28 Questions
Which type of assessment modality is NOT mentioned in the objectives of the chapter?
Genetic testing
What is a potential complication of head injuries that is NOT mentioned in the objectives?
Meningitis
Which condition is NOT specifically addressed in the objectives for nursing care?
Spinal cord injury
Which type of seizure characteristics is NOT included in the objectives?
Psychogenic non-epileptic seizures
What is the most popular scale used to assess the degree of depressed consciousness?
Glasgow Coma Scale (GCS)
What is the highest possible score on the Glasgow Coma Scale (GCS)?
15
What GCS score is generally accepted as a definition of coma?
8 or below
What does a GCS score of 3 indicate?
Severe head injury and deep, unresponsive coma or even brain death
What is the clinical manifestation of increased intracranial pressure in infants and children that involves separated cranial sutures?
Macewen sign
What is the term used to describe a severe reduction in level of consciousness where the child arouses with very strong stimulus but is close to a comatose state?
Obtundation
What is the term for permanently lost function of the cerebral cortex, where eyes follow objects only by reflex or when attracted to the direction of loud sounds?
Persistent vegetative state (PVS)
What is the definition of Neurological Determination of Death (NDD)?
Irreversible loss of the capacity for consciousness combined with the irreversible loss of all brainstem functions
What are the minimum clinical criteria required for Neurological Determination of Death (NDD) in Canada?
Proof of etiology and absence of reversible causes of coma
What are the components of the Glasgow Coma Scale (GCS) assessment?
Eye opening, verbal response, and motor response
What is the term for impaired decision making and decreased level of consciousness?
Confusion
What are the levels of consciousness that involve orientation to person, place, and time, and appropriate behavior for age?
Full consciousness
What can the persistence or reappearance of reflexes in infants indicate?
Pathological condition
What is the importance of obtaining pregnancy and birth history in pediatric neurological assessment?
Identifying potential environmental influences on central nervous system maturation
What is the significance of assessing the level of alertness in pediatric neurological examination?
Assessing neurological status
What can altered states of consciousness refer to?
Various levels of alertness
What can early signs and symptoms of increased intracranial pressure include?
Headache and vomiting
What is the primary response mode for neurological assessment in children younger than 2 years?
Reflexive
What might the delay or deviation from expected developmental milestones help identify in children?
Neurological issues or developmental delay
What can increased intracranial pressure be caused by?
Tumors
What is the significance of family history and health history in pediatric neurological assessment?
Identifying genetic disorders
What is the earliest indicator of improvement or deterioration in neurological status?
Assessment of level of consciousness
What is the significance of assessing head size and shape in pediatric neurological examination?
Detecting abnormalities or anomalies
What can altered states of consciousness include?
Various levels of unconsciousness
Study Notes
Pediatric Neurological Dysfunction Assessment
- Head trauma, increased intracranial pressure (ICP), and altered states of consciousness are common neurological disorders in pediatric population.
- Neurological assessment in infants requires evaluation of progressively sophisticated communicative and adaptive behaviors.
- Delay or deviation from expected developmental milestones helps identify children at high risk for neurological issues or developmental delay.
- Persistence or reappearance of reflexes in infants may indicate a pathological condition.
- Obtaining pregnancy and birth history is important to determine possible impact of intrauterine environmental influences on central nervous system maturation.
- Family history and health history can provide valuable clues regarding the cause of dysfunction.
- Physical examination includes assessment of level of alertness, head size and shape, sensory responses, motor function, and cranial function, among others.
- Children younger than 2 years require special evaluation for neurological assessment as they primarily respond reflexively.
- Increased intracranial pressure can be caused by tumors, space-occupying lesions, bleeding, or edema of cerebral tissues.
- Early signs and symptoms of increased ICP are often subtle and include headache and vomiting, leading to deterioration in level of consciousness.
- Altered states of consciousness refer to varying states of unconsciousness, including coma, which is a state of unconsciousness from which the patient cannot be roused.
- Assessment of level of consciousness remains the earliest indicator of improvement or deterioration in neurological status, and it can be affected by the child's environment and familiarity of voices.
Test your knowledge of pediatric neurological dysfunction assessment with this quiz. Explore key concepts such as head trauma, increased intracranial pressure, altered states of consciousness, developmental milestones, reflexes, and physical examination. Gain insight into the importance of obtaining pregnancy and birth history, family history, and health history in identifying potential neurological issues in children.
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