Nervous System Development and Anatomy

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Questions and Answers

Which developmental milestone is typically observed during later intrauterine development of the nervous system?

  • The fetus responds to stimuli (correct)
  • Initial formation of neural tube
  • Development of the brainstem
  • Formation of the spinal cord

What is the primary function of the cerebrum within the central nervous system?

  • Serving as the center of consciousness (correct)
  • Regulating involuntary body functions
  • Transmitting sensory information to the brain
  • Controlling motor coordination and balance

How many pairs of cranial nerves are part of the peripheral nervous system?

  • 24 pairs
  • 31 pairs
  • 43 pairs
  • 12 pairs (correct)

If a patient exhibits difficulty in regulating heart rate and digestion, which part of the nervous system is MOST likely affected?

<p>Autonomic nervous system (B)</p> Signup and view all the answers

In stressful situations, the sympathetic nervous system elicits which physiological change?

<p>Dilation of pupils (B)</p> Signup and view all the answers

What physiological response is associated with the parasympathetic nervous system?

<p>Increased gut motility (B)</p> Signup and view all the answers

Which of the following components form the protective layers surrounding the brain?

<p>Dura mater, arachnoid membrane, and pia mater (C)</p> Signup and view all the answers

What process primarily maintains intracranial pressure balance?

<p>Production and absorption of CSF (B)</p> Signup and view all the answers

What is the primary purpose of myelination in the nervous system?

<p>Increasing nerve fiber insulation for efficient motor control (D)</p> Signup and view all the answers

Which of the following assessments is typically included in a pediatric neurological evaluation?

<p>Reflex assessment (C)</p> Signup and view all the answers

A patient who is awake but unable to think clearly and is bewildered is MOST accurately described as:

<p>Confused (C)</p> Signup and view all the answers

Proprioception contributes to which sensory function?

<p>Determining body position in space (C)</p> Signup and view all the answers

Which condition is characterized by an absence of both hemispheres of the brain, with only the brainstem and cerebellum present?

<p>Anencephaly (A)</p> Signup and view all the answers

Exposure to Zika virus during pregnancy is MOST strongly associated with which congenital neurological disorder?

<p>Microcephaly (C)</p> Signup and view all the answers

What is a key characteristic of encephalocele?

<p>Herniation of brain and meninges through a skull defect (D)</p> Signup and view all the answers

What type of defect is present in myelomeningocele, a form of Spina Bifida?

<p>Protruding sac containing CSF, meninges and spinal cord portion (A)</p> Signup and view all the answers

Which assessment is MOST critical immediately after birth for a newborn with a suspected neural tube defect?

<p>Assessing head circumference (A)</p> Signup and view all the answers

Why is it important to keep a myelomeningocele sac moist with sterile gauze?

<p>To prevent infection and leakage of CSF (C)</p> Signup and view all the answers

In the care of a child with a neural tube defect, what nursing consideration is essential due to potential allergies?

<p>Latex precautions (D)</p> Signup and view all the answers

During the immediate interventions for a child experiencing a near-drowning incident, what is the FIRST priority?

<p>Establishing an airway (C)</p> Signup and view all the answers

What is a crucial nursing intervention for an infant born prematurely with intraventricular hemorrhage (IVH)?

<p>Minimizing handling and reducing stimuli (B)</p> Signup and view all the answers

Which exposure poses the greatest risk for lead poisoning in young children?

<p>Lead-based paint (A)</p> Signup and view all the answers

A child presents with gastrointestinal upset, a metallic taste in their mouth, and altered mental status. Which condition would the nurse suspect?

<p>Lead Poisoning (D)</p> Signup and view all the answers

What is a key characteristic of meningococcal meningitis that differentiates it from other types of meningitis?

<p>Presence of a purple rash or petechiae (B)</p> Signup and view all the answers

What assessment findings are indicative of meningitis in an infant?

<p>Poor feeding habits, irritability, and high-pitched cry (C)</p> Signup and view all the answers

What nursing intervention is critical when caring for a child with meningitis?

<p>Measuring head circumference (D)</p> Signup and view all the answers

Which of the following is MOST closely associated with Reye syndrome?

<p>Aspirin use during a viral illness (C)</p> Signup and view all the answers

What is an important nursing intervention for a child with Reye syndrome to prevent further complications?

<p>Monitoring carefully for progression through the stages of Reye Syndrome (B)</p> Signup and view all the answers

What nursing assessment is essential for a patient with Reye Syndrome?

<p>Electrolyte imbalances (D)</p> Signup and view all the answers

What indicates a complete spinal cord injury (SCI)?

<p>Complete loss of sensory function and motor control below the injury site (D)</p> Signup and view all the answers

Upon initial assessment of a child with a suspected spinal cord injury (SCI), which intervention has top priority?

<p>Placing the patient on a straight backboard with neutral head/neck alignment and cervical collar (D)</p> Signup and view all the answers

Which of the following is TRUE regarding primary and secondary brain injuries associated with TBI?

<p>Primary injuries occur when the body tissue suffers initial damage. (B)</p> Signup and view all the answers

For an adolescent, what is a key teaching point for preventing traumatic brain injuries (TBI)?

<p>Using protective equipment, especially helmets and seatbelts (A)</p> Signup and view all the answers

What BEST describes a concussion?

<p>Transient loss of consciousness from shearing/compression of brain's nerve tissue (C)</p> Signup and view all the answers

Which set of assessment findings is MOST indicative of increased intracranial pressure (IICP)?

<p>Widening pulse pressure, bradycardia, and irregular breathing patterns (A)</p> Signup and view all the answers

After a traumatic bain injury (TBI) , what intervention is used to decrease ICP?

<p>HOB raised to decrease ICP (D)</p> Signup and view all the answers

What is a priority nursing consideration after head trauma?

<p>Monitoring changes in clinical presentation (B)</p> Signup and view all the answers

Which type of brain tumor is MOST prevalent in children under the age of seven?

<p>Medulloblastoma (D)</p> Signup and view all the answers

Which intervention is MOST important for the nurse when providing care for a client with a brain tumor?

<p>Following neuro exams as ordered (C)</p> Signup and view all the answers

Which of the following has not been categorized as causing migraines?

<p>Bacterial headaches (A)</p> Signup and view all the answers

During which period of development does the nervous system first begin to form?

<p>Early embryonic development (B)</p> Signup and view all the answers

What is the total number of spinal nerve pairs that comprise a component of the peripheral nervous system?

<p>31 (A)</p> Signup and view all the answers

The autonomic nervous system (ANS) is primarily responsible for which bodily functions?

<p>Involuntary functions such as digestion and heart rate (C)</p> Signup and view all the answers

What response does the sympathetic nervous system (SNS) elicit during stressful situations?

<p>Increased alertness and dilated pupils (A)</p> Signup and view all the answers

Which physiological change is associated with activation of the parasympathetic nervous system?

<p>Stimulation of digestion (A)</p> Signup and view all the answers

What are the three protective membranes that surround the brain called?

<p>Dura mater, arachnoid membrane, pia mater (A)</p> Signup and view all the answers

Which process primarily maintains intracranial pressure (ICP) balance in the brain?

<p>Production and absorption of cerebrospinal fluid (CSF) (A)</p> Signup and view all the answers

What is the function of myelination within the nervous system?

<p>To increase the efficiency and speed of nerve impulse transmission. (A)</p> Signup and view all the answers

During a pediatric neurological assessment, which reflex is evaluated to assess neurological function?

<p>Moro reflex (C)</p> Signup and view all the answers

Which term describes a state of consciousness where a patient is sluggish, apathetic, and difficult to arouse?

<p>Lethargic (B)</p> Signup and view all the answers

Proprioception, a sense of body awareness in space, depends on which sensory function?

<p>Spatial orientation (C)</p> Signup and view all the answers

In anencephaly, which parts of the brain are typically absent at birth?

<p>Both hemispheres of the brain (A)</p> Signup and view all the answers

What neurological condition is most closely associated with exposure to the Zika virus during pregnancy?

<p>Microcephaly (A)</p> Signup and view all the answers

What is an encephalocele?

<p>A sac-like protrusion of the brain and meninges through a skull defect. (A)</p> Signup and view all the answers

In myelomeningocele, a form of spina bifida, what type of defect is typically present?

<p>Protrusion of the spinal cord and meninges through an opening in the spine (B)</p> Signup and view all the answers

For a newborn with a suspected neural tube defect, what immediate assessment is MOST critical?

<p>Evaluating the integrity of the protruding sac (A)</p> Signup and view all the answers

Why is maintaining the moisture of a myelomeningocele sac with sterile gauze so important?

<p>To prevent the drying of the meninges and reduce the risk of infection (A)</p> Signup and view all the answers

What allergy is of particular concern when caring for a child with a neural tube defect?

<p>Latex allergy (C)</p> Signup and view all the answers

Which of the following is the immediate priority for a child experiencing a near-drowning incident?

<p>Ensuring effective ventilation and oxygenation (B)</p> Signup and view all the answers

For a premature infant with intraventricular hemorrhage (IVH), what is the most important nursing intervention?

<p>Minimizing handling and reducing stimuli (D)</p> Signup and view all the answers

In young children, which source of exposure poses the greatest risk for lead poisoning?

<p>Lead-based paint in older homes (D)</p> Signup and view all the answers

A child exhibits symptoms of gastrointestinal distress, a metallic taste, and altered mental status. Which condition should the nurse primarily suspect?

<p>Lead poisoning (D)</p> Signup and view all the answers

What is a key distinguishing symptom of meningococcal meningitis compared to other types of meningitis?

<p>Purple rash or petechiae (A)</p> Signup and view all the answers

For an infant, which assessment findings are most indicative of meningitis?

<p>High-pitched cry and bulging fontanels (A)</p> Signup and view all the answers

What is a critical nursing intervention when caring for a child diagnosed with meningitis?

<p>Administering broad-spectrum antibiotics promptly (B)</p> Signup and view all the answers

Reye syndrome is most closely associated with the use of which medication?

<p>Aspirin (C)</p> Signup and view all the answers

What is a critical nursing intervention for a child with Reye syndrome to prevent complications?

<p>Monitoring for increased intracranial pressure (ICP) (C)</p> Signup and view all the answers

In patients with Reye syndrome, what nursing assessment is of utmost importance?

<p>Evaluating liver function and neurological status (A)</p> Signup and view all the answers

What defines complete spinal cord injury (SCI)?

<p>Complete loss of sensorimotor and reflex activity below the injury site (B)</p> Signup and view all the answers

Which action is the highest priority during the initial assessment of a child with a suspected spinal cord injury (SCI)?

<p>Stabilizing the spine to prevent further injury (B)</p> Signup and view all the answers

Regarding primary and secondary brain injuries associated with TBI, which statement is TRUE?

<p>Primary injuries result from the initial trauma, while secondary injuries evolve from the body's response to the trauma (B)</p> Signup and view all the answers

For adolescents, what is the most crucial teaching point for preventing traumatic brain injuries (TBI)?

<p>Wearing helmets during recreational activities (C)</p> Signup and view all the answers

What statement best describes a concussion??

<p>Transient loss of consciousness from shearing/compression of brain's nerve tissue (A)</p> Signup and view all the answers

What set of assessments is most indicative of increased intracranial pressure (IICP)?

<p>Decreased heart rate, increased blood pressure, and irregular respirations (C)</p> Signup and view all the answers

Following a TBI, which intervention is typically used to decrease intracranial pressure (ICP)?

<p>Elevating the head of the bed (B)</p> Signup and view all the answers

What is the most prevalent type of brain tumor found in children under the age of seven?

<p>Medulloblastoma (C)</p> Signup and view all the answers

For a client with a brain tumor, what intervention is most important for the nurse to implement?

<p>Providing support for the family (D)</p> Signup and view all the answers

What nursing consideration is important to implement to manage migraine headaches?

<p>Take a holistic approach (C)</p> Signup and view all the answers

Flashcards

Early Nervous System Development

The nervous system begins to form during early embryonic development.

Peripheral Nervous System (PNS)

The peripheral nervous system consists of 12 pairs of cranial nerves and 31 pairs of spinal nerves.

Cerebrum Function

The cerebrum is the center of consciousness and is divided into two hemispheres.

Autonomic Nervous System (ANS)

The autonomic nervous system controls involuntary body functions.

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Sympathetic Nervous System (SNS)

Sympathetic nervous system prepares the body for 'fight or flight'.

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Parasympathetic Nervous System

The parasympathetic nervous system influences muscle tone and facilitates relaxation of sphincter muscles.

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Intracranial Pressure Balance

Maintained by production/absorption of CSF, blood vessel dilation/constriction, and hormone regulation.

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Myelination

It's the formation of a protective coating around nerve fibers for motor control and cognitive maturity.

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Full Consciousness

Normal consciousness; alert, oriented, communicating.

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Confused (level of consciousness)

Reduced awareness; bewildered and unable to think clearly.

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Disoriented (level of consciousness)

Not oriented to person, place, or time; deep confusion.

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Lethargic (level of consciousness)

Being sluggish, apathetic, and unable to stay aroused.

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Obtunded (level of consciousness)

Loss of sensitivity to one's surroundings.

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Cerebral Palsy (CP)

A congenital condition that can occur during fetal development or during the birthing process, often caused by anoxia.

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Neural Tube Defects

Neural tube defects include conditions such as anencephaly, microcephaly, encephalocele, & spina bifida.

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Anencephaly

Born with absence of both hemispheres; brainstem and cerebellum present ONLY.

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Microcephaly

Child is born with abnormally small head and brain.

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Encephalocele

Child is born with a protruding sac of fluid causing the brain & meninges to herniate through a skull defect.

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Myelomeningocele

Portion of vertebral column isn't closed, protruding sac w/ CSF, meninges, and spinal cord.

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Lead Poisoning

Irreversible impairment of brain function and can lead to encephalopathy.

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Meningitis

Inflammation of the membranes of the brain or spinal cord.

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Meningococcal Meningitis

If bacterial, this one is a medical emergency with 90% mortality rate.

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Reye Syndrome

Nonspecific, noninflammatory encephalopathy involving liver, spleen, kidney, pancreas, and lymph.

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Increased Intracranial Pressure (IICP)

Caused by cerebral edema–abscesses, meningitis, tumors, water, intoxication, hypoxia, hydrocephalus, etc.

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Seizure Disorders

Occurs when the brain fires electrical stimulation between neurons when it's not supposed to.

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Infantile Spasms

Generalized seizure in infants (3-12 months); peaks at 4-8 months.

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Evaluating Seizures

Family history of seizures, or neurological impairments.

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Concussion

Transient loss of consciousness from shearing/compression of brain's nerve tissue; mild TBI.

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Contusion (brain)

Localized bruising of brain tissue; traumatic brain injury.

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Complete SCI

Complete loss of sensorimotor and reflex activity below the site of injury

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Incomplete SCI

Preservation of some motor/sensory function below site if injury

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Sympathetic nervous system

Emergency response to stimuli

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Non Hydrocephalus

Normal amount of CSF in the ventricles

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Central Nervous System

Brain and spinal cord make up the CNS

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Cerebrum Divisions

Frontal, Temporal, Parietal, Occipital lobes and Diencephalon

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List Cranial Nerves

I. Olfactory, II. Optic, III. Oculomotor, IV. Trochlear, V. Trigeminal, VI. Abducens, VII. Facial, IX. Glossopharyngeal, X. Vagus, XI. Spinal accessory, XII. Hypoglossal

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Cerebral Palsy (CP) signs

Tight muscles, scissors movement, joint contractures, paralysis, tremors, floppy extremities and pain.

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Cerebral Palsy Types

Ataxic, Spastic, Hypotonic, Dyskinetic, Mixed

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Neural Tube Defect Interventions

Handle sac with care, assess leaks, keep sac moist, family education

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Evaluating Neural Tube Defects

Perform early fetal assessment, ultrasounds during pregnancy

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Drowning and Near Drowning

Drowning peak periods are in toddler and later adolescence

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Tonic-Clonic Seizure

Full body neuromuscular activity, including aura and movement

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Absant Seizure

Brief episode of staring or checking out w/ possible twitching. Common in children.

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Traumatic Brain Injury - Primary

The time of trauma when brain tissue suffers initial damage.

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Traumatic Brain Injury - Secondary

Develops as the body is responding to the injury.

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Brain Tumors: Nursing

Support for the family, education on follow up care

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Evaluating Hydrocephalus

Frequent measuring of head circumference

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Hydrocephalus

Too much CSF in the brain

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Increased Intracranial Pressure

Cause brain, stem, apnea and death if not treated

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Seizure: Nursing Consideration

  • Adolescents must be without seizure for on year to obtain Dl
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Study Notes

Development of The Nervous System

  • In early embryonic development, the nervous system starts forming.
  • During intrauterine development, the fetus responds to stimuli.
  • After birth, the nervous system continues its development.
  • Development of the nervous system includes the brain and spinal cord.

Central Nervous System (CNS)

  • The CNS consists of the brain and spinal cord.
  • The brain includes the cerebrum, the center of consciousness.
  • The cerebrum is divided into two hemispheres.
  • The CNS includes the frontal, temporal, parietal, and occipital lobes, as well as the diencephalon, cerebellum, and brainstem.
  • The diencephalon consists of the Thalamus and Hypothalamus.

Peripheral Nervous System (PNS)

  • The PNS includes 12 pairs of cranial nerves and 31 pairs of spinal nerves.

Cranial Nerves

  • The cranial nerves are Olfactory (I), Optic (II), Oculomotor (III), Trochlear (IV), Trigeminal (V), Abducens (VI), Facial (VII).
  • The cranial nerves are Glossopharyngeal (IX), Vagus (X), Spinal Accessory (XI), and Hypoglossal (XII).

Autonomic Nervous System (ANS)

  • The ANS controls involuntary body functions.
  • The Sympathetic Nervous System (SNS) provides emergency response to stimuli, known as "fight or flight."
  • The Parasympathetic Nervous System influences muscle tone and the relaxation of sphincter muscles, known as "rest and digest."
  • The Sympathetic and Parasympathetic Nervous Systems have different effects on various body structures.

Anatomy of The Brain

  • Includes three protective membranes: dura mater, arachnoid membrane, and pia mater.
  • Cerebral spinal fluid (CSF) forms in the brain's lateral ventricles.

Intracranial Pressure Balance

  • Maintained by the production/absorption of CSF within the brain.
  • Maintained by blood vessel dilation/constriction within the brain.
  • Maintained by Production/circulation of hormones that increase or decrease urine production.

Myelination

  • Myelination involves the formation of a protective coating around nerve fibers.
  • Myelination is essential for motor control, coordination, and cognitive maturity.

Pediatric Neurological Assessment

  • Includes detailed health history, physical examination, lab studies, and diagnostic tests.
  • Assessing reflexes like Moro’s, sucking, fencing/tonic, plantar, Palmer, Babinski's, rooting, stepping, crawling, and step.

Levels of consciousness

  • Full consciousness includes being alert, oriented, and communicative.
  • Confusion causes a reduced awareness of being and inability to think clearly.
  • Disorientation includes not oriented to person, place, or time with a deepened state of confusion.
  • Lethargy includes being sluggish, apathetic, and unable to stay aroused.
  • Obtunded is a loss of sensitivity to one's surroundings.
  • Coma is deep unconsciousness.

The Senses

  • The Senses include: Auditory, Olfactory, Tactile, Visual, Gustatory and Proprioception.
  • Proprioception is sense of space.

Congenital Neurological Disorders

  • Cerebral Palsy, Anencephaly, Microcephaly, Encephalocele, Spina Bifida, Type 1 Meningocele, Type 2 Meningocele.

Cerebral Palsy (CP)

  • CP can occur during fetal development or during the birthing process.
  • It is caused by anoxia before, during, and after the birth process, up to the second year of life.

Cerebral Palsy Types

  • Ataxic, Spastic, Hypotension, Dyskinetic, Mixed.

Evaluating Cerebral Palsy

  • Includes tight muscles that do not stretch, "scissors" movements of arms and legs, and joint contractures with limited range of motion (ROM).
  • It can also include paralysis/muscle weakness, tremors, floppy extremities/overextension of joint areas, and pain.

Cerebral Palsy Nursing Interventions/Considerations

  • Interventions include: providing support, symptom management, promoting mobility/socialization, and reduce injuries.
  • Considerations include: reducing complications, teaching family airway maintenance, ROM exercises, and ensure SAFETY.

Neural Tube Defects

  • Anencephaly, Microcephaly, Encephalocele, Spina Bifida, Type 1: Myelomeningocele, and Type 2: Meningocele.

Anencephaly

  • A child is born with the absence of both hemispheres and the presence of the brainstem and cerebellum.

Microcephaly

  • A child is born with an abnormally small head and brain.
  • Exposure to the Zika virus is associated with congenital Zika syndrome and can lead to skull collapse.

Encephalocele

  • A child is born with an abnormal sac of fluid that causes the brain and meninges to herniate through a defect in the skull.
  • Brain tissue may be found within the sac.

Spina Bifida

  • Myelomeningocele causes the vertebral column not to close completely and protrude a sac that contains CSF, meninges, and part of the spinal cord.
  • 80% are located in the lumbosacral areas.
  • Meningocele causes the spinal column to have a defect that results in an abnormal protrusion of CSF-filled sac.

Evaluating Neural Tube Defects

  • Early fetal assessment, ultrasounds during pregnancy.
  • Measure head circumference and assess for neurological deficiencies, bowel, and bladder function.

Neural Tube Defect Interventions

  • Handle abnormal sac with care and assess for leaks, rupture, and infection in CNS and keep sac moist with NS-soaked gauze, as well as family education.
  • Post-op care: involves fluid balance measurement, ROM exercises, support lower extremities. Also perform intermittent catheterization.

Neural Tube Defect Nursing Considerations

  • Latex allergy, education on motor limitations, and education on the importance of folic acid.

Neurological Injuries

  • Neurological Injuries include: Drowning, Near Drowning, Intraventricular Hemorrhage (IVH), Lead Poisoning, Meningitis, Reye's Syndrome, Spinal Cord Injury (SCI) and Traumatic Brain injury (TBI).

Drowning and Near Drowning

  • Peak periods are in toddler and later adolescence periods.
  • Evaluation: Check airway, ventilation, ability/quality of respirations, HR, BP, ABGs, and LOC.
  • Interventions: CPR and Ventilators and provide oxygen support and IV fluids. Remove wets clothes and provide a warm environment and warm blankets.
  • Nursing Considerations: Offer support team, and family and contact social worker and spiritual support.

Intraventricular Hemorrhage (IVH)

  • Rupture of vascular network in germinal matrix leads to brain bleed.
  • Evaluation: If premature (<32 Weeks)

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