Quiz

Pediatric Neurological Disorders: Symptoms, Diagnosis, and Nursing Care

• Subtle symptoms of increased intracranial pressure (ICP) include irritability, behavioral changes, headache when lying flat, nausea/vomiting, sleepiness, blurred vision, and poor feeding.
• Infants with increased ICP may present with a bulging fontanel, cranial suture separation, high-pitched cry, increased head circumference, sun setting eyes, and retention of infantile reflexes.
• Cushing's Triad, characterized by increased systolic blood pressure, decreased heart rate, and decreased respirations, is a late sign of increased ICP.
• Diagnosis of increased ICP is dependent on the manifestations and can be confirmed through ICP monitoring or a burr hole.
• Nursing interventions for increased ICP include maintaining proper positioning (HOB 30-35 degrees), monitoring respiratory function, managing elevated temperature, and monitoring neuro checks.
• Unconscious patients should not be over-sedated, and their lung sounds, skin integrity, and nutrition should be assessed.
• Medical management of increased ICP may involve the use of barbiturates to decrease brain metabolism, vasopressors to decrease blood pressure, and various medications to control seizures.
• Surgical interventions for increased ICP may include the placement of an extra ventricular drain or a closed drainage system (VA or VP shunt).
• Closed head injuries occur when there is a forcible collision between the brain and the skull, leading to brain, blood, and CSF damage.
• Minor clinical manifestations of closed head injuries include brief or no loss of consciousness, vomiting, headache, lethargy, and transient confusion.
• Severe closed head injuries are characterized by increased ICP, altered LOC, unsteady gait, elevated temperature, CSF leakage, and eye changes.
• Treatment for closed head injuries includes symptom management, avoiding sedatives, and restricting school and sports activities until recovery.
• Meningitis is an infection or inflammation of the meninges, with bacterial meningitis being the most severe form.
• Clinical manifestations of meningitis include signs of increased ICP, fever, nuchal rigidity, and positive Kernig and Brudzinski signs.
• Diagnosis of meningitis is confirmed through a lumbar puncture.
• Treatment for viral meningitis includes supportive care, while bacterial meningitis requires immediate treatment with antibiotics and steroids.
• Nursing care for meningitis includes monitoring ICP and LOC, implementing droplet precautions, administering antibiotics and antipyretics, and ensuring hydration.