Pedi Neuro RNSG 1412
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Learning Guide
Nursing Care of the Pediatric Individual with a
Neurological Disorder
1.
What are the components of a neurological assessment?
a. Reflexesb. LOCc. Cranial nerves
d. Vital Signse. Eyesf. Behavior –
g. Respiratory Statush. Motor functioni. SkinINCREASED INTRACRANIAL PRESSURE:
2. Compare the clinical manifestations of increased intracranial pressure (may
see abbreviated as IICP or ICP) between an infant and child?
3. What is the client with IICP "at risk for"?
4. What nursing assessment findings point to this condition
5. What diagnostic tests will the healthcare provider order? How will the nurse
prepare the client/family for these procedures?
6. Discuss the medications typically used in treating ICP:
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a. What assessment findings and lab values should the nurse monitor
in relation to these medications?
b. What priority instructions does the nurse provide for the client/family
related to discharge and home care of a client taking these
medications?
c. What implications are there for using research to improve practice
with the child experiencing IICP?
MYELODYSPLASIA (MENINGOMYELOCELE)/ SPINA BIFIDA:
8. Differentiate between the 6 types of neural tube defects
a. anecephaly:
b. encephalocele:
c. spina bifida occult:
d. spina bifida cystica;
e. Meningocele:
f. Meningomyelocele (spina bifida)
8. What common nutritional supplement do healthcare providers encourage for
all women of childbearing age? Why?
9. What are the two priority nursing diagnosis for a newborn identified with a
neural tube defect in the pre-operative period?
a.
b.
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10. What priority interventions does the nurse initiate for the neonate with
spina bifida?
11. What are post-operative goals and nursing interventions for the newborn
following repair of spina bifida?
12. How will the nurse facilitate infant/parent attachment in the pre/postoperative period?
13.Who should the nurse include in the long-term-care team of a child diagnosed with
spina bifida?
14. What priority nursing assessment of a newborn monitors for hydrocephalus?
15. What assessment findings occur in the older child once the cranial sutures
have sealed? –
16. What diagnostic measures confirm the diagnosis of hydrocephaly? What are
the nursing responsibilities when preparing the child/family for these
procedures?
17. What is the purpose of a shunt?
18. Differentiate between the two types of shunts:
a. Atrioventricularb. Ventricular peritoneal19. A child who has undergone surgical placement of a shunt is at risk for what
3 complications?
1.
2.
3.
20. What are the priority nursing interventions for pre-operative care of a
newborn or child with hydrocephaly?
21. Post-operative care includes monitoring the child's vital signs and
neurological status. What additional assessment areas should receive high
priority? Please list specific interventions/ assessments
a. Shunt functionb. Position of the client –
c. Activityd. Incision sitee. I & Of. Nutrition22. What significant teaching must the nurse include when instructing the
client/family related to long-term care of a child with a shunt for hydrocephaly?
CEREBRAL PALSY:
23. What are the clinical manifestations, general and physical, related to
cerebral palsy?
24. What assessment findings would the nurse expect to find on the child's
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health history?
25.Why do these children experience failure to thrive?
26. What is the primary psychosocial goal for the client with cerebral palsy?
27. What significant findings would a metabolic work up indicate about a child
with CP? Why is this level elevated?
28. What is the most priority complication of cerebral palsy? What nursing
interventions and teaching will the nurse include to prevent this complication?
.
29. What additional long-term complications/ needs does this child/family
experience?
30. What members of the healthcare team are included in the care of this child? What
additional support do the parents/caregivers require?
SEIZURES:
31.Differentiate between the types of seizures:
a. Febrileb. Partialc. Generalized
d. Absence seizures32. How does a nurse distinguish between altered mental status, jitteriness,
and seizure activity?
33. What is the primary nursing goal when caring for the individual
experiencing a seizure?
a.What preventive measures does the nurse provide?
b.How does the nurse maintain the airway of an individual experiencing
a seizure?
c.What is the priority nursing intervention following a seizure?
34. What is the long-term goal or focus of treatment when caring for a child
experiencing seizure activity?
35. What information does the nurse include when teaching the child/ family
about the action, side effects, contraindications and necessary interventions
required with seizure medication?
36. What is the rationale for continuing the medications until the primary care
provider decreases the dosage gradually? Why is it important to stress this
teaching with the parents/ care givers?
HEAD INJURIES
37. What pre-disposes the infant/young child to head injury?
38. What is the pathophysiology involved in shaken baby syndrome?
39. What assessment findings would the nurse visualize that implicate shaken
baby syndrome?
40. What immediate treatment does the nurse initiate?
41. What are the legal implications for the nurse when assessment findings
indicate possible abuse of an infant or child?
42. Why is it not prudent for the nurse to discuss suspicions of abuse with the
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parents or primary caregivers?
MENINGITIS
43. What is the primary organism responsible for causing bacterial
meningitis?
44. How is diagnosis made of meningitis? .
45. What are the defining features between viral and bacterial meningitis?
46. What precautions need to be taken if one is exposed to a child with a
diagnosis of bacterial meningitis?
47. What nursing interventions would be a priority for teaching the parents if their child
has meningitis?
48. What are complications of meningitis?
Pervasive Developmental Disorders / AUTISM
49. Describe the clinical manifestations of autistic spectrum disorder.
50. What interventions would the nurse initiate when caring for the autistic
child center on each of the following needs?
DOWNS SYNDROME
51. What chromosomal anomaly is associated with Down's syndrome?
52.Describe the physical assessment findings that a nurse identifies in the
initial assessment of a newborn that indicate Down's syndrome or another
chromosomal anomaly:
g. Faciali. nose:
ii. eyes:
iii. mouth:
h. Earsi. Neckj. Handsk. Abdomenl. Cardiac53 If the nurse visualizes any of the outward signs of Down's syndrome what
is the immediate priority nursing assessment to perform next?
54. What are nursing measures used in promoting health of the child with
Down's syndrome?
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