QUESTIONS WITH ANSWERS GRADED A+
✔✔Risk factors for Reye Syndrome - ✔✔Potential association between using aspirin
products for treating fevers caused by viral infections and development of this syndrome
viral illnesses (gastroenteritis, influenza, varicella)
(NOT haemophilus influenzae.. it's bacterial)
✔✔Reye's Syndrome symptoms - ✔✔Lethargy
irritability
combativeness
confusion
delirium
profuse vomiting
seizures
loss of consciousness
✔✔Reye's Syndrome lab values - ✔✔liver enzymes ALT and AST increased
increase serum ammonia level
altered serum electrolytes
✔✔nursing care for reyes syndrome - ✔✔Maintain hydration (IV fluids, I&O, foley if
needed)
Position (avoid extreme flexion, extension, rotation; head midline neutral position, HOB
elevated 30 degrees)
Monitor coagulation (check for prolonged bleeding, apply pressure, prepare Vit K)
Monitor for pain
Assist w/ procedures (NG tube, intubation, ventilator)
Sz precautions
✔✔Reye's syndrome: medications - ✔✔Osmotic diuretic: mannitol
Vitamin K
✔✔Mannitol - ✔✔Osmotic Diuretic
decrease cerebral swelling
Consideration: monitor for increase ICP
✔✔Vitamin K - ✔✔improves synthesis of blood clotting factors in the liver
consideration: SQ route, teach client about dietary intake.
,✔✔complications of Reyes Syndrome - ✔✔- Neurologic (speech/hearing impairment,
cerebral palsy, paralysis, developmental delays)
- Death (family grief, spiritual support)
✔✔Risk factors for seizures - ✔✔-febrile episodes
-cerebral edema
-intracranial infection or hemorrhage
-brain tumor or cysts
-anoxia
-toxins or drugs
-lead positioning
-hypoglycemia, hypocalcemia, alkalosis, hyponatremia, hypernatremia, or
hypomagnesemia.
-sodium imbalances
-high serum lead levels
✔✔Risk factors for epilepsy - ✔✔● Trauma
● Hemorrhage
● Congenital defects
● Anoxia
● Infection
● Toxins
● Hypoglycemic injury
● Uremia
● Migraine
● Cardiovascular dysfunction
✔✔tonic-clonic seizure - ✔✔generalized seizure in which the patient loses
consciousness and has jerking movements of paired muscle groups.
✔✔Tonic phase of seizure - ✔✔10-30 seconds
eyes roll upward
loss of consciousness
tonic contraction of entire body.
mouth snaps shut and tongue can be bitten.
piercing crying
flushing
BP and HR increases
loss of swallowing reflexes
Apnea leading to cyanosis
increase salviation
✔✔clonic phase of seizure - ✔✔30-50 seconds
violent jerking movements of body
trunk and extremities experience rhythmic contraction and relaxation
foaming in mouth
, incontinent of urine or feces
gradual slowing of movements until cessation
✔✔postictal state of seizure - ✔✔(30 mins)
remains semi conscious but arouses with difficulty
confused for several hours.
impairment of fine motor movements.
lack of coordination.
sleeps for several hours.
possible vomiting, headache, or visual disturbances.
feels tired and complains of sore muscles.
no recollection of seizure.
✔✔Absence seizures (petit mal) - ✔✔Between ages 5 to 8 yrs.
Loss of consciousness lasting 5 to 10 seconds
-minimal or no change in behavior.
-resembles daydreaming or inattentiveness
-can drop items being held
-lip smacking, twitching of eyelid or face.
-unable to recall episodes
-immediately presume to previous activities.
✔✔Myoclonic seizure - ✔✔Brief shock-like jerks of a muscle or group of muscles.
Can involve only face and trunk or one or more extremities.
Might not lose consciousness
variety of seizure episodes
✔✔Atonic or akinetic seizures - ✔✔between 2-5 years
muscle tone is lost for a few seconds, period of confusion follows.
loss of muscle tone frequently results in falling.
if frequent child should wear helmet to prevent injury.
✔✔west syndrome (infantile spasms) - ✔✔Sudden, brief, symmetric muscle
contractions
flexed head, extended arms with legs drawn up.
possible loss of consciousness
possible flushing, pallor, or cyanosis
possible giggle or cry before or after
possible eye deviation or nystagmus
flexed head, extended arms with legs drawn up
*twice as common in boys; peak between 3 to 7 months. dos not occur after 18 months
✔✔Aversive seizure - ✔✔eyes and head turn away from the side of focus, with or
without loss of consciousness. (most common)