NUR 340 Exam Questions Solved 100% Correct
Neurological Differences in the Child
- Greatest neurological changes in life happen in the first year of life and prenatally, progressive
gyri/sulci
- Brain volume is readily reflected in head circumference
- Cerebral blood flow and oxygen consumption are 2X that of an adult
- Childhood development is directly related to brain growth and development
- Progressive myelinization = progressive motor function
Why do children respond differently to brain injury or disease?
- Expandable skull (d/t open fontanelles)
- Great blood volume in the brain
- Blood brain barrier is more permeable (More susceptible to brain infections)
Small epidural space
- fewer epidural hemorrhages (birth to 2 yo), but other hemorrhage sites are common
Neurological Assessment of the Child
- history
- constitutional
- HEENT
- respiratory
- CV
- GI
,- GU
- skin
- musculoskeltal and neuro
Neurological Assessment of the Child: history
- Fall/Trauma
- Exposure
- Febrile Illness (lead to meningitis)
- Animal Bite Onset
- Chronic Illnesses
Neurological Assessment of the Child: constitutional
- Crying
- Lethargic
- Irritable
- Drowsy
- Alert/active
Neurological Assessment of the Child: HEENT
- Head circumference (≤ 2yo) (plot it with ht and wt on chart)
- Fontanelles
- Pupils
- EMV
HEENT
,head, eyes, ears, nose, throat
Neurological Assessment of the Child: respiratory
- Is the LOC affecting the patient's ability to oxygenate?
- EMV less than 8 = INTUBATE.
Neurological Assessment of the Child: CV
BP and HR
Neurological Assessment of the Child: GI
- Gag reflex
- Emesis (may improve headache, increase ICP)
Neurological Assessment of the Child: GU
- incontinence and not before
- disease process?
- what is developmentally normal for the childs age?
Neurological Assessment of the Child: Skin
- rash
- thermoregulation (increase or decrease)
Neurological Assessment of the Child (musculoskeletal and neuro)
- Muscle strength
- Persistence of primitive reflexes
- Extremity
, - gait appropraite for age (wobble with concussion)
- decorticate
- decerebrate
- contractures
- spastic/flaccid
- muscle tone
- developmental delay
GCS peds
modified bc cant speak
eyes bilateral fixed and dialated
• Brain herniation, 5 minutes to intervene to save brain
• HOWEVER, assess this: Recent dilation with ophthalmic drops, can persist 48 hour
Babinski reflex
- stimulation sole of foot stroked
- response fans out toes and twists foot in
- duration dissapears at nine months to a year
blinking reflex
- stimulation flash of light or puff of air
- response close eyes
- duration permanent
grasping
Neurological Differences in the Child
- Greatest neurological changes in life happen in the first year of life and prenatally, progressive
gyri/sulci
- Brain volume is readily reflected in head circumference
- Cerebral blood flow and oxygen consumption are 2X that of an adult
- Childhood development is directly related to brain growth and development
- Progressive myelinization = progressive motor function
Why do children respond differently to brain injury or disease?
- Expandable skull (d/t open fontanelles)
- Great blood volume in the brain
- Blood brain barrier is more permeable (More susceptible to brain infections)
Small epidural space
- fewer epidural hemorrhages (birth to 2 yo), but other hemorrhage sites are common
Neurological Assessment of the Child
- history
- constitutional
- HEENT
- respiratory
- CV
- GI
,- GU
- skin
- musculoskeltal and neuro
Neurological Assessment of the Child: history
- Fall/Trauma
- Exposure
- Febrile Illness (lead to meningitis)
- Animal Bite Onset
- Chronic Illnesses
Neurological Assessment of the Child: constitutional
- Crying
- Lethargic
- Irritable
- Drowsy
- Alert/active
Neurological Assessment of the Child: HEENT
- Head circumference (≤ 2yo) (plot it with ht and wt on chart)
- Fontanelles
- Pupils
- EMV
HEENT
,head, eyes, ears, nose, throat
Neurological Assessment of the Child: respiratory
- Is the LOC affecting the patient's ability to oxygenate?
- EMV less than 8 = INTUBATE.
Neurological Assessment of the Child: CV
BP and HR
Neurological Assessment of the Child: GI
- Gag reflex
- Emesis (may improve headache, increase ICP)
Neurological Assessment of the Child: GU
- incontinence and not before
- disease process?
- what is developmentally normal for the childs age?
Neurological Assessment of the Child: Skin
- rash
- thermoregulation (increase or decrease)
Neurological Assessment of the Child (musculoskeletal and neuro)
- Muscle strength
- Persistence of primitive reflexes
- Extremity
, - gait appropraite for age (wobble with concussion)
- decorticate
- decerebrate
- contractures
- spastic/flaccid
- muscle tone
- developmental delay
GCS peds
modified bc cant speak
eyes bilateral fixed and dialated
• Brain herniation, 5 minutes to intervene to save brain
• HOWEVER, assess this: Recent dilation with ophthalmic drops, can persist 48 hour
Babinski reflex
- stimulation sole of foot stroked
- response fans out toes and twists foot in
- duration dissapears at nine months to a year
blinking reflex
- stimulation flash of light or puff of air
- response close eyes
- duration permanent
grasping
