neurological function and dysfunction

    Cards (30)

    • fetal development weeks 3 to 4
    • infection, trauma, teratogens, and malnutrition can cause physical defects and may affect normal CNS development
    • Birth: cranial bones not well developed or fused: increased risk for fracture, brain is highly vascular: increased risk for hemorage
    • child: spine is mobile; high risk for cervical spin injury
    • 12-18 months the anterior fontanels close
    • 2-3 months posterior fontanel close
    • Heat production and conservation
      • chemical reactions of metabolism
      • skeletal muscle contraction
      • chemical thermogenesis
      • vasoconstriction
      • shivering
      • voluntary mechanisms
    • factors contributing to neurological disease in children:
      prematurity, difficult birth, infection during pregnancy, n/v, headache, chances in gait, falls, visual disturbances, recent trauma\
    • physical impairments: altered speech, vision and hearing, headaches, decreased coordination, fatigue, spasticity, paralysis, seizure disorders
    • cognitive impairments: problems with short and long-term memory, slowed thinking, decreased attention span, altered reading and writing abilities, difficulties with planning, sequencing and judgement
    • Emotional/behavioural impairments: decreased control over emotions, depression, anxiety, agitation, decreased social awareness, decreased ability to relate to people
    • confusion- A and O x3?, what is their baseline
    • delirium: lack of awareness, altered perception of environment
    • obtunded: slowed response, sleepy, like lethargy
    • stupor: excessively deep state of unresponsiveness
    • coma- completely unresponsive
    • nursing physical examination:
      • LOC
      • vital signs
      • increased ICP
      • inspection.of head and neck
      • cranial nerve function
      • reflexes
      • motor and sensory function
    • Glasgow coma scale- eye opening, verbal response, motor response
    • neurological assessment: pupils, eyes open, motor response, stimulus response
      • hand grip
      • muscle tone
      • fontanel
      • LOC
      • eye movement
      • mood
    • assessing LOC: Responsiveness to environment or stimuli
    • assessing LOC: pupil size and reactivity
    • assessing LOC: movement go extremities
    • assessing LOC: ability to maintain an airway
    • assessing LOC: changes in vitals, breathing patterns
    • assessing LOC: status of cranial nerves
    • assessing LOC: fontanel assessment
    • assessing LOC: orientation and cognitive function
    • cushion triad: bradycardia, increased BP, irregular response drive
    • s/s of increased ICP: headache, n/v, increased blood pressure, decreased mental abilities, poor orientation, double vision, pupils not responding to light changes, shallow breathing, seizure, loss of consciousness, coma
    • ICP caused by increased cerebral spinal fluid, tumour, infection
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