Child with Neurologic Disorder

• Tasha


  1. year-old girl
• Tasha is brought to an emergency department by her mother because she had a seizure
• Tasha's physician suspects she may have meningitis
• Tasha's parent is visibly upset
• Parent: '"Does this mean she'll always have seizures? How can she ever be independent?"'
• Previous chapters described normal growth and development in children and nursing care of children with disorders of other systems
• This chapter adds information about the dramatic changes, both physical and psychosocial, that occur when a child is born with a neurologic disorder
• Such information builds a base for care and health teaching for children with these disorders
• Neurologic disorders


  Encompass a wide array of problems resulting from congenital disorders, acquired dysfunction, infection, or trauma
• Many neurologic disorders can cause severe illness or life-threatening complications
• In the future, stem cell research may offer a cure for neurologic disorders, but in the present, because neural tissue does not regenerate like other body tissue, any nervous system degeneration is permanent
• Whenever possible, prevention must be the highest priority for keeping the nervous system healthy
• If degeneration has already occurred, nursing care focuses on helping the child and family develop strategies for dealing with the associated loss in mental or physical functioning, making the child comfortable, and providing an environment conducive to the child's development and self-esteem
• Two major causes of neurologic dysfunction in children are addressed in National Health Goals: bacterial meningitis and head injuries
• National Health Goals related to children with disabilities


  • Reduce the proportion of children and adolescents with disabilities who report being sad, unhappy, or depressed
  • Reduce the number of people 21 years of age and younger with disabilities who are in congregate care facilities
  • Increase the proportion of children and youth with disabilities who spend at least 80% of their time in regular education programs
• Nurses can help achieve these National Health Goals through education, safe care, and infection control
• Nursing research topics that could help prevent neurologic injury or disease and subsequent disability include: effective bicycle safety programs in schools and earlier parental recognition of meningitis symptoms
• Neurologic examination


  Covers six areas of neurologic functioning, including mental or cognitive processes as well as motor and sensory functioning
• Diagnostic tests like CT scans and lumbar punctures can be frightening for the child
• The anxiety of not knowing what is wrong and fearing the worst can make the waiting period for test results especially difficult for the child's parents
• Children who have permanent limitations may not be able to achieve in some areas
• Parents may initially only be able to focus on the short term, like whether the child will survive, before being able to look at the long-term picture
• Long-term care needs can be a source of stress, physically, emotionally, socially, and financially
• Numerous organizations are available to provide assistance and support for families of children with neurologic disorders
• Nursing interventions must address both short- and long-term needs of the child and family
• Evaluation should address not only the child's physical progress but also their level of self-esteem
• Further planning to maintain the child's self-esteem is necessary if the disorder is long-term
• Infections with ngi, yeast, tuberculosis, or protozoans into the CSF results in some decrease in glucose level
• Viral infections do not cause a decrease in CSF glucose and may occasionally cause a slight increase
• Increased albumin/globulin ratio


  Suggests infection or neurologic disorder
• Cerebrum, temporal lobe, frontal lobe, parietal lobe, occipital lobe, cerebellum, brain stem
• Ventricles of the brain: lateral ventricles, third ventricle, aqueduct of Sylvius, fourth ventricle
• Cerebrospinal fluid flows from the lateral ventricles into the third ventricle, then through the narrow aqueduct of Sylvius to the fourth ventricle
• Health history


  • Reveal symptoms of neurologic disorder
  • Obtain mother's pregnancy history
• Neurologic examination


  • Assess cerebral, cranial nerve, cerebellar, motor, sensory, and reflex function
• Cerebral function


  Evaluate level of consciousness, orientation, intelligence, performance, mood, and general behavior
• Immediate recall


  Ability to retain a concept for a short time
• Recent memory


  Covers a slightly longer period
• Remote memory


  Long-term recall
• Specific cerebral function


  Measure language, sensory interpretation, and motor integration