Pediatrics Exam 4 (FINAL) Questions with Complete Solutions
Chapter 16: Neurologic Disorder
chapter 16: p.517
Seizures - all types
A) Epilepsy: condition in which seizures are triggered
recurrently
- two or more, which occur more than 24 hours apart
-One unprovoked seizure, with a chance of one occurring in another 10 years -Diagnosis of epilepsy syndrome
tx: helping the child who has recurrent seizures and his family
to maintain a quality of life with seizures -Primary tx is use of anticonvulsants
Goal: use of fewest drugs possible, with the fewest side
effects
B) Infantile spasms:
-epileptic spasm seen in infancy : 3 to 12 month
s/x: occurs in series or clusters
-symetrical flexing or extending, in variant clinical patterns or neck arms legs and trunk -extension, flexion of extremities -Cry may precede of follow 1 / 4
Pediatrics Exam 4 (FINAL) Questions with Complete Solutions -Ifant seems to stop developing and may loose skills that he has already attained Tx: hormonal therapy: (CORTICOTROPIN) and anticonvulsants (VIGABATRIN )
- Absence seizures (P - Correct Answers ✅Nursing
Management :
Teaching guidelines 16.1: how to respond when your child has
a seizure -Remain calm -If a child is standing or sitting , EASE child to ground if possible -Time seizure episode
- Tight clothing and jewelry around neck should be loosened if
- Do not focibly ope jaw with tongue class
possible -Place child on one side and open airway if possible -Do not restrain child -Remove hazards in the area
-Document length of seizure and movements -Re main with child until fully conscious
-Call EMS if: the child stops breathing, an injury has occurred,
seizure lasts more than 5 minutes, this is the childs first seizure , child is unresponsive to painful stimuli after seizure 2 / 4
Pediatrics Exam 4 (FINAL) Questions with Complete Solutions Educate not only parents but the community to including teachers and care givers on the reality and facts of the disorder.
A) Febrile Seizures:
-Most cmmon type of seizure seen in children less than 5 years of age -associated with fever that is usually related to a VIRAL
ILLNESS.
- Febrile seizures may be a sign of dangerous underlying
infection such as meningitis or sepsis
note:
S/s: associated with rapid rise in core temp of 39C(102.2F)
-Simple febrile: less than 15 mins and occurs once in a 24
hour period
tx: The AA does not recommend long term or intermittent
anticonvulsant therapy for a child who has suffered one or more simple febrile seizures
1) Rectal Diazepam: is SAFE and effective in terminating
febrile seizures 3 / 4
Pediatrics Exam 4 (FINAL) Questions with Complete Solutions -may be used in children at high risk for febrile seizures or in children whose parents are extremely anxious
2) Buccal and Intranasal Midacolam: has been found effective
a
3) Intranasal Lorazepam:
Nurse management: provide support and education
- Counsel parents on controlling fever , discussing how to
- Ne
keep child safe and proper administration of rectal diazepam at onset of sesizure
Cp 16: p. 536
Encephalitis:
INFLAMMATION OF THE BRAIN
-Rare: caused by bacterial, fungal or viral illness
-Child suspected should be hospitalized
Assessment : hx of flue like symptoms, hx of recent travel,
hiking camping -Perform neurologic examination to distinguish between encephalitis and viral meningitis
- / 4