Peds - Neuro, Psych

vaccine derived from microorganisms or viruses; virulence has been weakened as a result of passage through another host.

Chronological - age in years

Developmental - based on child's maturational progress (body size, physical/psychological functioning, motor skills, aptitude tests)

Functional age - age equivalent at which a child actually is able to perform specific self-care or related tasks

Sound made by forced expiration. Body's attemp to improve oxygenation.

Widening of nares to enable an infant to take in more O2 - serious air hunger

Vaccines that contain killed microorganisms.

Immunity from injection or from mom. Doesn't last as long as acquired immunity.

Early symptoms marking onset of a disease.

Appetite suppression, weight loss, nervousness, tics, insomnia, increased blood pressure.

Minimize environmental stimulation, limit tv time, allow for lots of physical activity.

Safe environment!

Rigid, obsessive behavior characteristic of autism

involuntary writhing motions more severe distally

ex cerebral palsy

exaggerated posturing of back in cerebral palsy

hemi is upper extremities

di is lower

Administered intrathecally to inhibit motor nerve conduction in spinal cord. May cause hypotonia and increased seizures in children with epilepsy, sleepiness, n/v

monitor for pump failure and s/s of infection

Startle reflex. Lean baby back and they put arms out looking startled.

Dissappears at 3-4 months of age, usually

LOC

irritability, high-pitched cry, bulging fontanel, increased head circumference, dilated scalop veins, Macewen's sign (cracked-pot sound on percussion of the head), setting sun sign (sclera visible above the iris)

Increased resonence when infant's skull is tapped. Indicates absess, hemmorhage, or hydrocephalus

Communicating - impaired absorption of CSF

Noncommunicating - obstruction of CSF flow

Infant - high shrill cry, lethargy, feeding poorly

Toddler - Headache, loss of appetite

Older child - Alteration in LOC

CSF obtained by lumbar puncture. Fluid is cloudy with increased pressure, increased white blood cell count, elevated protein and decreased glucose.

Neck flexion causes adduction and flexion movements of lower extremities in children and adolescents.

Indicative of meningitis

Inability to extend the leg when the thigh is flexed anteriorly at the hip

Respiratory isolations for at least 24 hrs after antibiotics are initiated.

Antibiotics after lumbar puncture, anti-seizure meds, antipyretics

Neuro assessments

Watch for SIADH

Put them in side lying position

Dim lights, quiet room

Place child on apnea monitor

Measure head 1-2x/day

Strict I&O, daily weights, monitor electrolytes

Beware of needle sticks that ooze. May get DIC.

Hearing assessment

Family may need rifampin or ciprofloxin prophylactically

Strep or flu infections

Bulging fontanel, fever, change in feeding pattern, vomiting, diarrhea, cuddling/rocking only irritates infant with meningitis.

Petechaie, photophobia, esotropia (cross eyes), nuchal rigidity.

Assumes opisthotonic position to relieve discomfort (hyperextention of neck).

Positive Kernig or Brudinski sign

<70

Mental retardation is in people <21yo

Brain injury is in people over 21

Microcephaly
Flat forehead
Wide, short neck
Epicanthal eye folds
Brushfield spots (white spots on iris)
Congenital cataracts
Flat nose
Small, low-set ears
Protruding tongue
Short broad hands
Simian line on palm
Wide space b/w 1st and 2nd toes
Hearing loss
Increased incidence of diabetes, congenital heart defects, and leukemia
Hypotonia

Long face, prominent jaw, large ears, frequent otitis media, large testicles, epicanthal eye folds, strabismus, high-arched palate, scoliosis, pliable joints

Flat midface, low nasal bride, long philtrum with narrow upper lip, short upturned nose, poor coordination, fialure to thrive, skeletal and joint abnormalities, hearing loss

Acute encephalapathy and liver failure associated with giving kids aspirin products during a viral infection.
Seizures, N/V, progressive unresponsiveness, hypoglycemia, hyperammonemia

Aspirin and ASA containing products like pepto-bismol and alka-seltzer

no development of the brain above the brainstem

neural tube defect

protrusion of meningeal tissue or meningeal covered brain through defect in skull

neural tube defect

vertebral defect without visible protrusion of the meninges or spinal cord tissue; area lying over defect may have abnormal growth of hair, a dimple, sq mass, vascular skin lesion

neural tube defect

spinal fluid-filled meningeal sac protruding through a vertebral defect, associated with no abnormalities of the spinal cord

meningomyelocele involves the spinal cord too

neural tube defect

Prone, and cover the sac with sterile saline gauze.