6/5/2025
NEURO/CEREBRAL VASCULAR
DYSFUNCTION
NUR 3600 2024
Week 6
OBJECTIVES
Discuss the etiology, clinical presentation, treatment modalities,
and nursing care of the child with cerebral/ neuromusculoskeletal
dysfunction.
Relate pharmacological agents used for pediatric patients with
cerebral/neuromuscular-skeletal dysfunction.
Apply clinical judgment to the care of the pediatric client with
intracranial infections.
Describe importance of prevention of communicable diseases.
©Stanbridge University, 2025
EVALUATION OF NEUROLOGICAL STATUS
Include in routine physical for any age
group
Follow progression of disease progress
as needed
Follow up birth defects of head or spine
Review the history for headaches,
blurry vision, change in behavior,
numbness/tingling,
Seizures, tremors, slurred speech
Motor function and balance evaluated
Muscle strength ©Stanbridge University, 2025
1
, 6/5/2025
NEWBORN NEURO ASSESSMENT
Early detection allows early intervention into
neuro development treatment
Review birth history and any know defects
Assess neonatal reflexes – moro, grasp,
sucking, rooting, stepping
Assess fontanels, measure head
circumference for trend of measurements
Observe overall movement of extremities,
alertness and activity
©Stanbridge University, 2025
DIAGNOSTIC TESTING
Lab tests – CBC, glucose, BMP, blood
culture if fever present, evaluate for toxic
substances, liver function
Lumbar Puncture – LP
Radiology tests – CXR, CT scan, MRI scan,
Echoencephalograph,
Electroencephalogram(EEG), ultrasound,
Nuclear brain study, PET scan.
Skeletal xrays and skull series to rule out
fractures, dislocation or degenerative
©Stanbridge University, 2025 changes.
INCREASED INTRACRANIAL PRESSURE
Early signs may be subtle
Assess Level of consciousness, activity,
Causes of Increased ICP – infection,
structural, injury,
Glascow coma scale
How to decrease ICP?
HOB elevated
Hyperventilate
Mannitol
Score of 15: unaltered LOC
Score of 3: extremely decreased LOC
©Stanbridge University, 2025
2
, 6/5/2025
Child will be irritable, high- CLINICAL
pitched cry, agitated
HR, RR, BP elevated,
PRESENTATION OF
decreased Oxygen sats INCREASED ICP
Fontanelles buldging and
tense
Scalp veins distended
Macewen sign- a cracked pot
sound noted with percussion
of the head
Sunset eyes - failure of
upward gaze
©Stanbridge University, 2025
NURSING CARE FOR THE
CHILD WITH INCREASED ICP
Positioning
Airway management/oxygen
Avoid activities that may
increase ICP
Quiet environmental noise
Suctioning caution
IV fluids with caution
Gastric tube feedings,
aspiration cautions
©Stanbridge University, 2025
POSITIONING
Decorticate flexion towards
to the body – curl towards
the core of the body -
adduction
Decerebrate worsening
condition extension -
abduction
©Stanbridge University, 2025
3
NEURO/CEREBRAL VASCULAR
DYSFUNCTION
NUR 3600 2024
Week 6
OBJECTIVES
Discuss the etiology, clinical presentation, treatment modalities,
and nursing care of the child with cerebral/ neuromusculoskeletal
dysfunction.
Relate pharmacological agents used for pediatric patients with
cerebral/neuromuscular-skeletal dysfunction.
Apply clinical judgment to the care of the pediatric client with
intracranial infections.
Describe importance of prevention of communicable diseases.
©Stanbridge University, 2025
EVALUATION OF NEUROLOGICAL STATUS
Include in routine physical for any age
group
Follow progression of disease progress
as needed
Follow up birth defects of head or spine
Review the history for headaches,
blurry vision, change in behavior,
numbness/tingling,
Seizures, tremors, slurred speech
Motor function and balance evaluated
Muscle strength ©Stanbridge University, 2025
1
, 6/5/2025
NEWBORN NEURO ASSESSMENT
Early detection allows early intervention into
neuro development treatment
Review birth history and any know defects
Assess neonatal reflexes – moro, grasp,
sucking, rooting, stepping
Assess fontanels, measure head
circumference for trend of measurements
Observe overall movement of extremities,
alertness and activity
©Stanbridge University, 2025
DIAGNOSTIC TESTING
Lab tests – CBC, glucose, BMP, blood
culture if fever present, evaluate for toxic
substances, liver function
Lumbar Puncture – LP
Radiology tests – CXR, CT scan, MRI scan,
Echoencephalograph,
Electroencephalogram(EEG), ultrasound,
Nuclear brain study, PET scan.
Skeletal xrays and skull series to rule out
fractures, dislocation or degenerative
©Stanbridge University, 2025 changes.
INCREASED INTRACRANIAL PRESSURE
Early signs may be subtle
Assess Level of consciousness, activity,
Causes of Increased ICP – infection,
structural, injury,
Glascow coma scale
How to decrease ICP?
HOB elevated
Hyperventilate
Mannitol
Score of 15: unaltered LOC
Score of 3: extremely decreased LOC
©Stanbridge University, 2025
2
, 6/5/2025
Child will be irritable, high- CLINICAL
pitched cry, agitated
HR, RR, BP elevated,
PRESENTATION OF
decreased Oxygen sats INCREASED ICP
Fontanelles buldging and
tense
Scalp veins distended
Macewen sign- a cracked pot
sound noted with percussion
of the head
Sunset eyes - failure of
upward gaze
©Stanbridge University, 2025
NURSING CARE FOR THE
CHILD WITH INCREASED ICP
Positioning
Airway management/oxygen
Avoid activities that may
increase ICP
Quiet environmental noise
Suctioning caution
IV fluids with caution
Gastric tube feedings,
aspiration cautions
©Stanbridge University, 2025
POSITIONING
Decorticate flexion towards
to the body – curl towards
the core of the body -
adduction
Decerebrate worsening
condition extension -
abduction
©Stanbridge University, 2025
3
