NURS 400 Pediatrics Final Exam – Questions With
Proper Solutions
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Terms in this set (449)
Neuro - Pupils (round, equal, reactive to light, PERRLA)
- Cranial nerves
What's the same as with adults - Grip equal strength
- Reflexes
- Numbness/tingling/sensation
- Glasgow coma scale (age-specific versions)
- Gait assessment
- Purposeful movement (gravving a toy with purpose,
if they follow you walking across a room).
- N/V
- Headache
- Photophobia
- Neck stiffness
- Seizures
- Posturing
- General tone (moro reflex will show us true tone in
infants)
Neur - Milestones --> are they meeting them? Falling
behind? Regressing?
What is child or infant specific? - Cry --> What is the pitch of their cry? --> NEURO
CRY
- Fontanels/head circumference -->
Bulging/increased size could be a sign of increased
pressure
- Assessing LOC and orientation --> May need to
adjust how you phrase questions, may not be able to
ask questions due to developmental level at baseline,
ask parents about normal LOC and personality.
- Changes in feeding
,What are examples of head trauma - Increased intracranial pressure
- Hydrocephalus
- Skull fractures
- Contusions and lacerations
- Hematomas
- Concussions
What is increased intracranial pressure Pressure rising in the intracranial space for any
(ICP) reason
What are 3 causes of increased ICP 1. Infection/Illness
2. Head trauma
3. Congenital malformation
What types of infection/illness cause - Meningitis
increased ICP - Encephalitis
- Diabetic Ketoacidosis (DKA) w/ cerebral edema
What types of head trauma cause - Traumatic brain injuries
increased ICP - Non-accidental trauma
What types of congenital - Hydrocephalus
malformations cause increased ICP - Arteriovenous malformations (AVMs)
The ability of the child's skull to Age.
expand and accommodate the - Younger children have more flexible skulls
increased pressure is dependent on - Infants with open fontanels can withstand more
pressure
The amount of pressure and the rate at which it
develops can determine which symptoms develop
and when.
- If it comes on really quickly, the s/s will come on
really quickly as well.
,What are symptoms of increased ICP - Increased head circumference
in infants - Bulging or tense fontanels
- Change in LOC or personality
- Irritability, restlessness
- High-pitched cry, difficult to soothe
- Distended scalp veins
- Separation of cranial sutures
- Macewen (cracked pot) sign --> separation of
suture lines are visible
- Setting-sun signs (eyes)
- Bradycardia
- Respiratory changes
What is macewen's sign A resonant 'cracked pot' sound that occurs when a
child's suture lines are percussed, often accompanied
by enlarged bluish scalp veins.
What is setting-sun (eyes) From pressure on eye balls, it pushes them forward
, What are symptoms of increased ICP - Headache
in children - Nausea (maybe)
- Forceful vomiting with or without nausea
- Blurred vision (Diplopia)
- Sleepiness
- Weight loss
- Seizures
- Behavioral changes
- Irritability, restlessness, "Seems off"
- Decreased school performance
- Inability to follow simple commands
- Memory loss
1 of 2
What are late signs of increased ICP? - Cushing's Triad Signs
--> Bradycardia + Hypotension + Respiratory distress =
Impending herniation!!!
- Cheyne-Stokes respirations = death rattle
- Sluggish pupillary response/pupils of 2 different
sizes or reactivity
- Blown pupil or fixed pupil
- Lack of response to painful stimuli --> nail bed
pressure or sternal rubbing
- Decreased general motor response
- Posturing = decorticate or decerebrate (worse)
- Papilledema = inflammation of the optic nerve due
to elevated ICP --> need to complete
ophthalmological exam to see this
- Coma
- Death
Proper Solutions
Save
Terms in this set (449)
Neuro - Pupils (round, equal, reactive to light, PERRLA)
- Cranial nerves
What's the same as with adults - Grip equal strength
- Reflexes
- Numbness/tingling/sensation
- Glasgow coma scale (age-specific versions)
- Gait assessment
- Purposeful movement (gravving a toy with purpose,
if they follow you walking across a room).
- N/V
- Headache
- Photophobia
- Neck stiffness
- Seizures
- Posturing
- General tone (moro reflex will show us true tone in
infants)
Neur - Milestones --> are they meeting them? Falling
behind? Regressing?
What is child or infant specific? - Cry --> What is the pitch of their cry? --> NEURO
CRY
- Fontanels/head circumference -->
Bulging/increased size could be a sign of increased
pressure
- Assessing LOC and orientation --> May need to
adjust how you phrase questions, may not be able to
ask questions due to developmental level at baseline,
ask parents about normal LOC and personality.
- Changes in feeding
,What are examples of head trauma - Increased intracranial pressure
- Hydrocephalus
- Skull fractures
- Contusions and lacerations
- Hematomas
- Concussions
What is increased intracranial pressure Pressure rising in the intracranial space for any
(ICP) reason
What are 3 causes of increased ICP 1. Infection/Illness
2. Head trauma
3. Congenital malformation
What types of infection/illness cause - Meningitis
increased ICP - Encephalitis
- Diabetic Ketoacidosis (DKA) w/ cerebral edema
What types of head trauma cause - Traumatic brain injuries
increased ICP - Non-accidental trauma
What types of congenital - Hydrocephalus
malformations cause increased ICP - Arteriovenous malformations (AVMs)
The ability of the child's skull to Age.
expand and accommodate the - Younger children have more flexible skulls
increased pressure is dependent on - Infants with open fontanels can withstand more
pressure
The amount of pressure and the rate at which it
develops can determine which symptoms develop
and when.
- If it comes on really quickly, the s/s will come on
really quickly as well.
,What are symptoms of increased ICP - Increased head circumference
in infants - Bulging or tense fontanels
- Change in LOC or personality
- Irritability, restlessness
- High-pitched cry, difficult to soothe
- Distended scalp veins
- Separation of cranial sutures
- Macewen (cracked pot) sign --> separation of
suture lines are visible
- Setting-sun signs (eyes)
- Bradycardia
- Respiratory changes
What is macewen's sign A resonant 'cracked pot' sound that occurs when a
child's suture lines are percussed, often accompanied
by enlarged bluish scalp veins.
What is setting-sun (eyes) From pressure on eye balls, it pushes them forward
, What are symptoms of increased ICP - Headache
in children - Nausea (maybe)
- Forceful vomiting with or without nausea
- Blurred vision (Diplopia)
- Sleepiness
- Weight loss
- Seizures
- Behavioral changes
- Irritability, restlessness, "Seems off"
- Decreased school performance
- Inability to follow simple commands
- Memory loss
1 of 2
What are late signs of increased ICP? - Cushing's Triad Signs
--> Bradycardia + Hypotension + Respiratory distress =
Impending herniation!!!
- Cheyne-Stokes respirations = death rattle
- Sluggish pupillary response/pupils of 2 different
sizes or reactivity
- Blown pupil or fixed pupil
- Lack of response to painful stimuli --> nail bed
pressure or sternal rubbing
- Decreased general motor response
- Posturing = decorticate or decerebrate (worse)
- Papilledema = inflammation of the optic nerve due
to elevated ICP --> need to complete
ophthalmological exam to see this
- Coma
- Death
