Neurologic Assessment
What is the earliest indicator of improvement or deterioration in neurologic status?
What is level of consciousness?
This sense is often the last to be lost and the first to be regained in a comatose child.
What is hearing?
After a head injury, this structure should be stabilized until spinal injury can be ruled out.
What is the spine?
These items can be brought from home to provide a sense of comfort and familiarity to a hospitalized child.
What are familiar items? (such as toys, blanket, clothes, etc)
This is foundational in preventing CNS infections like bacterial meningitis.
What are vaccinations.
Name 3 key reflexes that demonstrate neurologic health in infants
What are Moro, Tonic neck, and withdrawal?
Bleeding in this type of hematoma is generally arterial, resulting in rapid brain compression.
What is an epidural hematoma?
This is the first priority in the management of submersion injuries.
What is restoring oxygen delivery to the cells?
The nurse should do this to prevent skin breakdown in an unconscious child who is unable to move.
What is turning the child frequently and/or using a pressure-relieving mattress?
This precaution is initialed and maintained for at least 24 hours after antibiotics in bacterial meningitis.
What is respiratory isolation.
A high-pitched cry from infants is often associated with disorders of this system.
What is the central nervous system?
These medications are given to control or prevent seizures.
What are antiepileptics? (like fosphenytoin or Phenytoin)
This pupil finding is a neurosurgical emergency.
What is a fixed and dilated pupil?
This item should be administered regularly to an unconscious child to prevent corneal irritation.
What are artificial tears?
If there is evidence of increased ICP in a patient with suspected meningitis, this diagnostic procedure should be done first?
What is a CT scan?
This procedure is contraindicated when increased ICP is expected because of the risk of brainstem herniation.
What is a lumbar puncture?
This medication can be given to treat DI, which can occur as a complication of head trauma.
What is vasopressin?
This osmotic diuretic is often used for the rapid reduction of increased ICP.
What is mannitol?
To avoid increasing intracranial pressure, the nurse should decrease environmental stimuli by doing this.
What is decreasing noxious procedures?
This is the most common cause of death in children with bacterial meningitis.
What is cerebral edema?
Two conditions must be met to declare a child brain dead. One is complete cessation of clinical evidence of brain function and the other is this.
What is irreversibility of the condition?
This type of skull fracture often presents with cerebrospinal fluid leaking from the nose and ears.
What is a basilar skull fracture?
What is establishing an adequate airway?
To avoid jugular compression and help to reduce ICP, the child should be kept in this position.
What is midline and head of bed 15-30 degrees?
Along with seizures, cerebral edema, and SIADH, this may be an acute complication of meningitis.
What are subdural effusions?