Summary NURS475 Child Health Exam 3: Intercranial Regulation, Neuro & Pediatri Emergencies

NURS475 Child Health Exam 3: Intercranial Regulation, Neuro &
Pediatri Emergencies

1. Full consciousness: the child is awake and alert; is oriented to time,
place, and person; and exhibits age-appropriate behaviors.
2. Confusion: disorientation exists; the child may be alert but responds
inappropri- ately to questions.
3. Obtunded: the child has limited responses to the environment and
falls asleep unless stimulation is provided.
4. Stupor: the child only responds to vigorous stimulation.
5. Coma: the child cannot be aroused, even with painful stimuli
6. Early signs of ICP: • Headache

• Vomiting, possibly projectile

•Blurred vision, double vision (diplopia)

•Dizziness

•Decreased pulse and respirations

•Increased blood pressure or pulse pressure

•Pupil reaction time decreased and unequal

•Sunset eyes

•Changes in level of consciousness, irritability

•Seizure activity

•In infant will also see:

•Bulging, tense fontanel

•Wide sutures and increased head circumference

•Dilated scalp veins

•High-pitched cry
7. Late signs of ICP: Lowered LOC

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, NURS475 Child Health Exam 3: Intercranial Regulation, Neuro &
Pediatri Emergencies

Decreased motor and sensory

responses Bradycardia

Irregular respirations

Cheyne-Stokes

respirations

Decerebrate or decorticate posturing

Fixed and dilated pupils
8. Management for ICP: •Shunt placement

• Ventilation

• Physical therapy, occupational therapy

• External ventricular drainage

• Ventricular tap

• Vagal Nerve Stimulator

• Ketogenic diet

•Ativan
9. Ketogenic diet for seizures: high fat, low carb, adequate protein

AVOID FRUIT, BEER, POTATOES, RICE, BREAD, AND SUGAR
10.Meds for ICP?: •Antibiotics

• Anticonvulsants

• Benzodiazepines

• Analgesics

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