Flashcards in Neurologic Dysfunction (Part 2) - Unit 3 Deck (76)
What is hydrocephalus?
Water on the brain
What are the two types of hydrocephalus?
Non-obstructive or communicating
What is obstructive/non communicative hydrocephalus?
Obstruction to the flow of CSF within ventricles - developmental, neoplasma, infection, trauma, etc.
What is non-obstructive or communicating hydrocephalus?
Impaired absorption or CSF within subarachnoid - LESS COMMON and same signs and symptoms.
What are some signs of hydrocephalus?
Abnormal head growth (OFC), bulging fontanels, separated sutures, setting sun expression (sclera above iris), dilated scalp veins, irritability, high pitched cry, signs of increased ICP
How do we manage hydrocephalus?
Ventricular-Peritoneal Shunt (VP Shunt) - a catheter that runs sub-cutaneously from a ventricle in the brain to the peritoneal cavity. It grows with the child because it curls, and it's a one way valve so it keeps ICP at a normal level.
What should nurses do for kids with hydrocephalus?
Elevate HOB, keep pressure off shunt site, neuro checks, may start PO feeding as soon as awake!
What are complications of a VP shunt?
Malfunction, shunt infection (if happens, remove shunt, EVD, antibiotics), seizures
What percent of children have a seizure during childhood?
What are seizures?
Periods of abnormal electrical discharge that cause involuntary movement, sensation, and/or behavior alterations.
What causes a seizure?
Caused by malfunctions of brain's electrical system, fever, abnormal discharge cortical neuron cells.
What might trigger a seizure?
anxiety, fatigue, infection, metabolic disturbances, hypoxia, trauma.
Epilepsy - > or equal to __ "unprovoked" seizures.
Median age fro development of epilepsy is __ to __ years.
Idiopathic epilepsy - known cause. T/f?
A seizure that is caused by abnormal electrical activity in one hemisphere or a specific area of the cerebral cortex is referred to as a ___ or ___ seizure.
Focal or partial.
A seizure that begins simultaneously in both hemispheres and spreads throughout is referred to as a ____ seizure.
What is a tonic clonic seizure?
Grand-mal - loss of consciousness then muscle involvement.
What is an absence (petit mal) seizure?
Staring spell/brief loss of consciousness - Can have 50-100 daily!
What is a myoclonic seizure?
No LOC, involuntary muscle jerks occur
What are infantile spasms?
Occur in clusters with developmental delays around 3 months
What are atonic seizures?
LOC, lose tone, falls to ground
What kind of diet can be used to manage myoclonic and absence seizures?
Ketogenic Diet - 90% fat + LOW carbs - Ketosis is thought to have anticonvulsant effects.
After a seizure, we should just let them go. T/F?
No, turn on side, maybe suction, etc.
Drug Therapy for seizures - multiple drugs are preferred. T/F?
Nope - it's best to do monotherapy. If another is needed, we just lower Drug A and give drug B.
What is phenobarbital used for?
Febrile seizures, neonatal seizures
Phenobarbital - Front live IV choice is patient does not respond to diazepam. T/F?
High dose might require respiratory support. T/F?
Phenytoin (Dilantin) - slow or fast IV push?
precipitates when mixed with what?
What are some side effects of phenytoin?
Gingival hyperplasia, ataxia, rashes, acne, hirsutism, osteoprosis.