DIAGNOSTIC TESTS AND PROCEDURES
______ _______ is used for analysis of CSF and is contraindicated with increased ICP.
Lumbar puncture is used for analysis of CSF and is contraindicated with increased ICP.
The 3 types of seizures include:
1. _________ seizures (tonic-clonic, absence, atonic): __ hemisphere(s) involved.
2. _______ seizures (aware and _______): __ hemisphere(s) involved.
3. Unknown onset seizures: unclear of where onset originates
The 3 types of seizures include:
1. Generalized seizures (tonic-clonic, absence, atonic): 1 hemisphere involved
2. Focal seizures (aware and impaired): 2 hemispheres involved (entire brain)
3. Unknown onset seizures: unclear of where onset originates
____________ treatment includes an extracranial shunt with ___ shunt being the most common and require monitoring for _________. The biggest goal for treatment is?
Hydrocephalus treatment includes an extracranial shunt with VP shunt being the most common and require monitoring for infection. The biggest goal for treatment is relieving increased ICP.
Match the following words to the descriptions below:
Fracture types- A. Linear, B. Depressed, C. Diastatic, D. Basilar, E. Compound Skull
1. break in the base of the skull: __
2. break through sutures of skull: __
3. laceration of skin and splinter of bone: __
4. simple break that follows a straight line: __
5. broken and pushed inward causing pressure on the brain: __
Match the following words to the descriptions below:
Fracture types- A. Linear, B. Depressed, C. Diastatic, D. Basilar, E. Compound Skull
1. break in the base of the skull: D
2. break through sutures of skull: C
3. laceration of skin and splinter of bone: E
4. simple break that follows a straight line: A
5. broken and pushed inward causing pressure on the brain: B
Encephalitis is inflammation of the brain that causes _____, flu-like symptoms, alterations in LOC, headache, seizures, and lethargy.
Nursing management includes _____ and _____ control, management of fluid and electrolytes, and management of long-term neurological effects.
Encephalitis is inflammation of the brain that causes fever, flu-like symptoms, alterations in LOC, headache, seizures, and lethargy.
Nursing management includes pain and fever control, management of fluid and electrolytes, and management of long-term neurological effects.
Electroencephalograms (EEG) are used to measure the _______ activity of the _____ and diagnose _______, brain death, evaluate tumors, and assess hemorrhages.
Electroencephalograms (EEG) are used to measure the electrical activity of the brain and diagnose seizures, brain death, evaluate tumors, and assess hemorrhages.
Causes of seizures/diagnostics to rule out when exploring a diagnosis for epilepsy include:
1. Labs (_______ and blood glucose)
2. _____ _______ to assess CSF for meningitis and encephalitis
3. Imaging (xray, CT, MRI)
4. _____ (with or without video)
Causes of seizures/diagnostics to rule out when exploring a diagnosis for epilepsy include:
1. Labs (electrolytes and blood glucose)
2. Lumbar puncture to assess CSF for meningitis and encephalitis
3. Imaging (xray, CT, MRI)
4. EEG (with or without video)
**DAILY DOUBLE**
List and describe the 5 states of consciousness.
**DAILY DOUBLE**
List and describe the 5 states of consciousness.
1. full consciousness: awake and alert, A&Ox4, behavior appropriate to situation
2. confusion: disorientation present, may be alert but responds inappropriately
3. obtunded: limited response to environment, falls asleep without stimulation
4. stupor: only responds to vigorous stimulation
5. coma: unarousable, even with painful stimuli
Shaken Baby Syndrome is characterized by ________ head trauma caused by violent shaking.
Risk factors include: _______ and single parents, history of ______ ______ by parents, premature or sick child, colic, and family burdens.
Most important to educate on how to _____ the infant.
Shaken Baby Syndrome is characterized by non-accidental head trauma caused by violent shaking.
Risk factors include: young and single parents, history of substance abuse by parents, premature or sick child, colic, and family burdens.
Most important to educate on how to soothe the infant.
Clinical manifestations of bacterial meningitis are _______, vomiting, photophobia, stiff neck, rash, irritability, drowsiness, lethargy, muscle rigidity, and seizures. Infants may have poor _____, weak ____, and lay in an __________ position.
Clinical manifestations of bacterial meningitis are headache, vomiting, photophobia, stiff neck, rash, irritability, drowsiness, lethargy, muscle rigidity, and seizures. Infants may have poor suck, weak cry, and lie in an opisthotonic position.
The gold standard for ICP monitoring is direct _________ _______ measurement. These devices are sensitive to patient _______ and need to be leveled or turned frequently based on patient movement. Never adjust the _____ without _______ the EVD due to pressure differences.
The gold standard for ICP monitoring is direct ventricular pressure measurement. These devices are sensitive to patient position and need to be leveled or turned frequently based on patient movement. Never adjust the HOB without clamping the EVD due to pressure differences.
Treatment for epilepsy includes: __________ (goal= fewest drugs with fewest side effects), surgery (LITT and resections of affected areas of the brain), _______ diet, and placement of vagal nerve stimulator.
Antiepileptic side effects: ____, sleepiness, change in ______, ataxia/vision changes.
Treatment for epilepsy includes: anticonvulsants (goal= fewest drugs with fewest side effects), surgery (LITT and resections of affected areas of the brain), ketogenic diet, and placement of vagal nerve stimulator.
Antiepileptic side effects: rash, sleepiness, change in mood or behavior, ataxia/vision changes.
During the physical assessment of a 3-month-old infant, the nurse suspects hydrocephalus. Which symptoms did she observe? (select all that apply)
A. vertical nystagmus
B. pupils fixed
C. increased head circumference
D. protruding abdomen
E. bulging fontanels
During the physical assessment of a 3-month-old infant, the nurse suspects hydrocephalus. Which symptoms did she observe? (select all that apply)
C. increased head circumference
E. bulging fontanelles
The pediatric Glasgow Coma Scale includes questions to assess ____ opening, best ______ response, and best response to ______ stimuli separated into assessment for children younger and older than __ years.
The pediatric Glasgow Coma Scale includes questions to assess eye opening, best motor response, and best response to verbal stimuli, separated into two categories for children younger and older than 2 years.
If LP shows CSF with increased WBC but no bacterial growth, ______ _________ is likely.
This condition is similar to but less severe than ______ _________.
If LP shows CSF with increased WBC but no bacterial growth, aseptic meningitis is likely.
This condition is similar to but less severe than bacterial meningitis.
CNS has a dynamic fluid balance called ___, that bathes the brain and spinal cord at a specific _______ called ____.
CNS has a dynamic fluid balance called CSF, that bathes the brain and spinal cord at a specific pressure called ICP (intracranial pressure).
Epilepsy is a brain disorder that causes ________, unprovoked (inside) seizures due to a disruption of _________ communication among the neurons in the brain (firing from wrong spot or at wrong time).
In status epilepticus, check _____ _______, administer ________, antiepileptic agents: (3)
Epilepsy is a brain disorder that causes recurring, unprovoked seizures due to a disruption of electrical communication among the neurons in the brain (firing from wrong spot or at wrong time).
In status epilepticus, check blood glucose, administer oxygen, antiepileptic agents: lorazepam (Ativan), diazepam, phenytoin or fosphenytoin
__________ is an excess of CSF in the ventricles and subarachnoid spaces of the brain resulting from imbalance of production (too _____) or absorption (too _____) of CSF.
Hydrocephalus is an excess of CSF in the ventricles and subarachnoid spaces of the brain resulting from imbalance of production (too high) or absorption (too low) of CSF.
________=extremities are _______ inward
________=extremities are _______ and pronated outward
decorticate=extremities are flexed inward
decerebrate=extremities are extended and pronated outward
Bacterial meningitis treatment (in order of priority):
1. ___ with cultures
2. _________
3. _________
4. supportive measures
5. education
Bacterial meningitis treatment (in order of priority):
1. LP with cultures
2. antibiotics
3. corticosteroids
4. supportive measures
5. education
Intracranial pressure and _____ of _________ have an ________ relationship. _______ ICP=________ LOC.
Intracranial pressure and level of consciousness have an inverse relationship. Increased ICP=decreased LOC.
Febrile seizures occur in _ months to _ years old with a temperature higher than __C without any other possible cause.
Neonatal seizures occur in the first _ weeks of life, typically from an underlying cause.
Seizure precautions include NO _______, nothing in mouth, turn on side, _________, suction, time it, meds.
Febrile seizures occur in 6 months to 5 years old with a temperature higher than 38C without any other possible cause.
Neonatal seizures occur in the first 4 weeks of life, typically from an underlying cause.
Seizure precautions include NO RESTRAINTS, nothing in mouth, turn on side, pad side rails, suction, time it, meds.
Signs of infection in a shunt include poor _______, vomiting, seizures, impaired LOC, tachycardia, fever, inflammation along _____ ______. Infection indicates administration of _________ and externalization of the shunt until CSF is clear from infection.
Signs of shunt malfunction include increased _________ circumference, vomiting, drowsiness, and headache resulting from a blockage in the catheter.
Signs of infection in a shunt include poor feeding, vomiting, seizures, impaired LOC, tachycardia, fever, inflammation along shunt tract. Infection indicates administration of antibiotics and externalization of the shunt until CSF is clear from infection.
Signs of shunt malfunction include increased abdominal circumference, vomiting, drowsiness, and headache resulting from a blockage in the catheter.
Match the following words to the descriptions below:
Head injury types: A. subdural hematoma, B. concussion, C. epidural hematoma, D. contusion
1. injury caused by impact and results in disruption of electrical brain activity:
2. bruising of the cerebral tissue:
3. blood collection between dura and cerebrum:
4. blood collection outside dura but within the skull:
Match the following words to the descriptions below:
Head injury types: A. subdural hematoma, B. concussion, C. epidural hematoma, D. contusion
1. injury caused by impact and results in disruption of electrical brain activity: B
2. bruising of the cerebral tissue: D
3. blood collection between dura and cerebrum: A
4. blood collection outside dura but within the skull: C
_____ ________ is a rare disease that causes brain swelling, liver failure, and death within hours, presenting with elevated liver enzymes and serum ammonia, vomiting, decreased LOC, hyperreflexia, and confusion.
There are few exceptions when _______ is used in pediatrics.
Reye Syndrome is a rare disease that causes brain swelling, liver failure, and death within hours, presenting with elevated liver enzymes and serum ammonia, vomiting, decreased LOC, hyperreflexia, and confusion.
There are few exceptions when aspirin is used in pediatrics.