is an acute encephalopathy that follows a viral illness and is characterized pathologically by cerebral edema and fatty changes in the liver, a definite diagnosis is made by a liver biopsy
-exact cause is unclear, most commonly nfollows a viral illness such as influenza or varicella
-DONT administer aspirin (esp for children with a febrile illness, varicella or influenza)
-Instead use tylenol.
-Early diagnoisis and aggressive treatment are important; the goal of treatment is to maintain effective cerebral perfusion and control increasing ICP.
- => Assessment:
- 1. History of systemic viral illness 4-7 days before onsent of symtpotms.
- 2. Fever. N/V
- 3. Signs of altered Hepatic function such a s lethargy
- 4. Progressive neruo deteroiation
- 5. Increased blood ammonia levels.
Provide rest and decrease stimulation in envirnoment, asses neuro, monitor LOC and signs of Increased ICP, monitor I&O, and signso of bleeding, impaired coagulation (bleeding time)
ASA related, which is why we recommend children less than 18 years not take aspirin.
Liver rapidly replaced by fatty tissue and so they bleed, Require intracranial monitoring to decrease the pressure in the brain and to monitor them for disseminated intervascular coagulation b/c liver produces the clotting factors, so fat isn't producing clotter factors so naturally, they bleed!
Replace clotting factor with albumin? Bleed for IV site, ET tube, oozing blood from various places because no clotting factors.
To Rapid progression
decrease increase of brain pressure
Monitor for DIC
Replace clotting factors