Peds Neuro fnxn
Card Set Information
Peds Neuro fnxn
What are some terms for LOC?
Confused – lacks ability to think clearly and rapidly
Disoriented – lacks ability to recognize place or person
Lethargic – awakens easily but exhibits limited responsiveness
Obtunded – sleeps and, once aroused, has limited interaction with environment
Stupor – requires stimulation to arouse
Coma – vigorous stimulation produces no response
What are most deaths related to ICP caused by?
Increased pressure to the brain stem!
What is Cushing's Triad and what does it mean?
Indicative of ^ ICP
--changes in RR and pattern
(LOC may also be affected)
What are some SnSs of ^ICP in infants?
High-pitched cry, difficult to soothe
: tense, bulging
: separated/split = Increased OFC
: “setting-sun” sign
Increased or decreased response to pain
What are some SnSs of ^ICP in children?
Nausea and vomiting (especially in the morning, then fine for the rest of the day--> EMERGENCY!)
Diplopia, blurred vision
What are some behavioral SnSs of ^ICP?
Complains to fatigue/somnolence/drowsiness-->decreased activity.
Inability to follow commands, memory loss
What are some late SnSs of ^ICP?
• Severely Decreased LOC
• Decreased motor response to command
• Decreased sensory response to painful stimuli
• Alterations in pupil size and reactivity
• Papilledema (swelling of optic disc)
• Decerebrate or decorticate posturing
• Cheyne-Stokes respirations
(infrequent, irratic breathing-->impending death)
What are some examples of posturing associated with ^ICP?
What is the GLASCOW scale?
15 = best score
3 = worst (even dead pts will score 3)
Consists of best:
What can you do for a pt with ^ICP?
Don't do anything that will futher ^ICP, ie...
--turn down lights
--keep volumes down
--only suction to maintain airway
What is Hydrocephalus and what can you do about it?
Imbalance between the production and absorption of CSF.
Tx with shunt to abd or heart.
What are the 3 major causes of childhood head trauma?
(damage is typically caused by rapid acceloration/deceloration)
What is trauma caused by initial impact?
Which is more dangerous: Subdural or epidural hematoma?
: faster bleeding and faster ^ICP--> death quicker.
Following injury, child will have brief period of lucidity then prodeed to rapidly lost LOC.
What does SCIWORA?
Spinal Cord Injury Without Radiologic Abnormality
In infants, usually caused by shaking.
In older kids, MV trauma, falls, dives, or violence.
Tx with immobilization and steroids
What is the most common neuro dysfunction on children?
What is the difference between primary and secondary szr?
What are some possible etiologies of szr?
^ICP for any reason
Birth injury/congenital defects
Acute nfxn in late infancy/early childhood.
50% or idiopathic.
What is a febrile szr?
Usually at temps >38.8C (102F)
Occures as temp rises, not after
Almost always has no lasting neuro consequences
Rare after 5 yrs.
No tepid bath!
Call 911 if longer than 5 min
Protect child from trauma during szr.
What is Status Epilepticus?
Szr lasting more than 30 minutes continuous or in episodes without regaining normal LOC.
Get IV access
Rx with Diastat, IV Diazepam/Lorzepam, or Versed.
What are some other common anticonvusants?