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what week of gestation does the brain begin development?
Kernig's sign, Brudzinski's sign - implications of what?
- usually meningitis
- sometimes IVH
- flexion of upper extrem, extension of lower extrem
- implies injury to cerebral hemisphere
- extension of all extremities
- indicates more damage to brain, brainstem
- progression of damage from decorticate posturing
CSF normals? indications?
- fluid should be clear, colorless
- should NOT have WBCs
- meningitis, possible shunt infection, etc
CSF protein/glucose levels?
- glucose should not be low
- protein should not be high
- (think of pacman - eats up glucose).
most seizures are caused by what?
- disorders that originate outside the brain
- F/E imbalances
- high fever
partial focal seizures?
- starts in one hemisphere
- usually one-sided manifestations
- can become generalized
both hemispheres of brain
simple partial seizure vs complex partial?
- simple: remain in one hemisphere
- no impairment of LOC
- motor symptoms/hallucinations
- complex: starts in one hemis but spreads to both
- may have LOC
absence seizures (petite mal)
- kid becomes "out of it" - but no LOC
- sudden, quick onset. last 5-10 sec
- can have ~100 a day
- onset around 5 years, outgrows by school age
short muscle contractions
tonic-clonic (grand mal)
- violent, total body seizure
- rhythmic jerking
- drop and fall attack
- wear helmet
- suddetn brief loss of muscle tone/posture
- temporary LOC
- continuous seizures without interruption
- risk of cardiac/respiratory arrest, brain damage
- consciousness not regained
- last more than 30 min
- **rapid rise of temperature
- not necessarily how high the fever goes.
- one seizure per fever
nursing implications for seizures
- primary concern: safety. remove objects, equipment, etc
- document findings of seizures
- absence of entire brain
- brain stem or cerebellum may be present
meningeal/cerebral tissue protruding in sac through skull defect
- defective closure of verterbral column
- directly related to what spinal column it begins at
meningocele vs myelomeningocele
- myelo contains spinal cord.
- meningocele is only meninges
associated conditions/complications with spina bifida
- chiari malformation
- bowel obstructions
- hip subluxation
communicating vs non-communicating hydrocephalus?
- communicating: excess production of CSF
- noncommunicating: obstruction
ventriculoperitoneum shunt. drains CSF to extra-cranial compartment, usually peritoneum
major complication of VP shunts?
manifestations of meningitis?
- fever, chills
- changed LOC
- nuchal rigidity
- +Kernig's sign (pain when lifting leg to 90degrees)
- +Brudzinski sign (lift head, knees automatically also lift)
- petechial rash
- septic shock
spinal tap will reveal what for meningitis?
cloudy CSF, increased WBCs
most common permanent disability in childhood?
*nonprogressive* disorder of motor function
hypertonicity, posturing, impaired motor skills, drooling
abnormal involuntary motion, athetosis
poor coordination, balance, control of upper extremities, wide gait
main goal of therapy for CP children?
potentiate muscle function
red flags for CP
- not sitting by 8 months
- hypotonia, hypertonia
- one-sided function (crawling)/asymmetry (hemiplegia)
- persistent toe-walking