Brain / Neuro Basics
In a child with suspected ICP, why should the nurse avoid excessive neck flexion?
It can impair venous drainage and worsen ICP.
Why should the nurse limit unnecessary stimulation in increased ICP?
Answer: Can increase intracranial pressure
First nursing priority during an active seizure.
Protect airway and prevent injury
hild with meningitis becomes hard to arouse—priority?
Notify provider immediatly
Why are lights often dimmed for a child with meningitis?
Photophobia / sensitivity to light
A nurse notes unequal pupils in a neuro patient. What should this suggest first?
worsening neurological status / increased ICP
Priority assessment for any child with suspected neurological decline.
Level of consciousness
Seizure involving stiffening then rhythmic jerking.
What is tonic-clonic seizure?
Infant meningitis may present with bulging _____.
Fontanelle
Priority nursing action before first dose of antibiotics if ordered.
Obtain cultures
Sudden high-pitched cry, bulging fontanelle, and irritability in an infant may indicate what condition?
Increased intercranial pressure
A child opens eyes to pain only. Which AVPU level is this?
Pain
Seizure lasting longer than 5 minutes.
status epilepticus
Isolation type used initially for bacterial meningitis.
Droplet precautions
Why are seizure precautions often started for meningitis patients?
Risk of cerebral irritation / seizures
A child withdraws from painful stimulus but does not follow commands. Which neurological function is being tested?
Motor Response
Why are frequent neuro checks important after head injury?
Detect early deterioration quickly
Common emergency medication for prolonged seizure.
lorazepam / diazepam / midazolam
Priority nursing assessment with meningitis.
Frequent neuro checks
Decreased LOC, vomiting, unequal pupils, and bradycardia in meningitis suggest what complication?
Increased intracranial pressure
Why is repeated vomiting in a head injury patient considered a neurological warning sign?
Possible rising in intracranial pressure
A child only opens eyes when you call their name. Which AVPU level is this?
Voice
What should the nurse document after a seizure
Duration, movements, LOC, triggers, recovery phase.
Why must antibiotics be started quickly?
Prevent brain damage, sepsis, death
Why should fluid balance be closely monitored in meningitis?
Risk of SIADH / dehydration
Best position for a child with increased ICP unless contraindicated.
Head elevated, kept midline
Which pupil finding should concern the nurse in a neuro patient?
Unequal, sluggish pupils
Why never place anything in mouth during seizure?
Risk of injury/airway obstruction.
Purple rash with shock in meningitis suggests what complication?
meningococcemia
Isolation can usually be discontinued after effective antibiotics for approximately how long in bacterial meningitis?
24 hours (facility/provider dependent)
A child becomes bradycardic with irregular respirations and widened pulse pressure. This indicates what emergency?
Cushing’s Triad / late increased ICP
Sterile procedure used to obtain CSF.
umbar puncture (LP)
Important teaching for seizure meds.
Never stop abruptly and take exactly as prescribed
Classic symptom combination of meningitis in an older child.
Fever, headache, stiff neck
Priority pain-relief nursing intervention for severe headache in meningitis.
Reduce stimuli, analgesics as ordered, rest