Child with a Neurological Alteration Practice Exam Quiz
Which of the following is a common neurological sign in a child with a brain injury?
a) Hyperactivity
b) Seizures
c) Excessive crying
d) Difficulty swallowing
A 3-year-old child is brought to the emergency department after a head injury. The child is lethargic and vomiting. What should be the first priority in the management of this child?
a) Administering pain medication
b) Immediate CT scan of the head
c) Elevating the head of the bed
d) Administering fluids
Which of the following is most likely to be seen in a child with cerebral palsy?
a) Progressive muscle weakness
b) Seizures and cognitive delays
c) Progressive vision loss
d) Hearing loss and tinnitus
What is the first-line treatment for a child presenting with a febrile seizure?
a) Antiepileptic drugs
b) Cooling measures and fever reduction
c) Intravenous fluids
d) Steroids
Which of the following conditions is most commonly associated with increased intracranial pressure in children?
a) Meningitis
b) Autism spectrum disorder
c) Attention deficit hyperactivity disorder
d) Down syndrome
A 5-year-old child is diagnosed with hydrocephalus. What is the most likely treatment?
a) Antidepressants
b) Shunt placement
c) Antibiotics
d) Physical therapy
What is a common early sign of increased intracranial pressure in infants?
a) Bulging fontanel
b) Fever
c) Jaundice
d) Tachycardia
In a child with a seizure disorder, which of the following is an important teaching point for parents?
a) Discontinuing medications during an illness
b) Withholding food after a seizure
c) Keeping a safe distance and monitoring during a seizure
d) Encouraging the child to sleep after a seizure
Which is the most common cause of sudden neurological deterioration in a child with a history of a head injury?
a) Subdural hematoma
b) Stroke
c) Brain tumor
d) Meningitis
Which of the following is a typical manifestation of a child with a spinal cord injury at the C3-C5 level?
a) Paraplegia with preserved sensation
b) Quadriplegia with respiratory distress
c) Hemiplegia
d) Loss of hearing
Which of the following is the most appropriate nursing intervention for a child with a recent diagnosis of a brain tumor?
a) Encourage normal activity and play
b) Monitor for signs of increased intracranial pressure
c) Limit fluid intake
d) Encourage verbal communication at all times
What is the most common cause of seizures in infants less than 6 months of age?
a) Head trauma
b) Metabolic disorders
c) Meningitis
d) Cerebral palsy
A child with a history of seizures is prescribed a new medication. What is the most important aspect of the nurse’s teaching?
a) Monitor for signs of bleeding
b) Encourage hydration and frequent meals
c) Take the medication at the same time every day
d) Restrict fluid intake to prevent seizures
Which neurological disorder is characterized by the progressive loss of myelin in the central nervous system of children?
a) Multiple sclerosis
b) Guillain-Barré syndrome
c) Leukodystrophy
d) Huntington’s disease
What is a key characteristic of Duchenne muscular dystrophy in children?
a) Progressive loss of motor skills
b) Excessive appetite
c) Hearing impairment
d) Severe developmental delays
A 10-year-old child is diagnosed with meningitis. What is the most important intervention?
a) Provide a warm, quiet environment
b) Administer antibiotics as soon as possible
c) Offer frequent fluids
d) Keep the child in a supine position
Which of the following is the most appropriate intervention for a child with Guillain-Barré syndrome?
a) Initiate broad-spectrum antibiotics
b) Administer intravenous immunoglobulin (IVIG)
c) Restrict all physical activity
d) Perform a lumbar puncture
A 6-year-old child is being evaluated for attention deficit hyperactivity disorder (ADHD). Which of the following is a key diagnostic feature of ADHD in children?
a) Difficulty staying still and paying attention
b) Recurrent seizures
c) Loss of sensation in limbs
d) Impaired hearing and vision
What is the most appropriate action for a nurse when caring for a child after a lumbar puncture?
a) Place the child in a prone position
b) Encourage the child to drink plenty of fluids
c) Administer pain medication immediately
d) Keep the child in a lateral recumbent position for 24 hours
Which of the following signs is most likely to indicate a neurological emergency in a child?
a) Occasional headaches
b) Sudden onset of severe headache with vomiting
c) Frequent nosebleeds
d) Difficulty walking after an illness
A 2-year-old is diagnosed with a seizure disorder. The parents ask about the long-term outlook. What is the best response?
a) Most children will outgrow seizures by age 5.
b) The seizures may require lifelong treatment.
c) The seizures will stop without treatment.
d) Seizures are always associated with developmental delays.
Which of the following is a key diagnostic feature of pediatric encephalitis?
a) Hyperactivity
b) Acute onset of fever and altered mental status
c) Muscle rigidity and fever
d) Nausea and vomiting only
Which condition is most likely to cause developmental delay in a child with abnormal neurologic findings?
a) Cerebral palsy
b) Epilepsy
c) Meningitis
d) Autism spectrum disorder
Answer: a) Cerebral palsy
A child presents with sudden weakness and loss of vision in one eye. What is the most likely cause?
a) Multiple sclerosis
b) Traumatic brain injury
c) Seizure disorder
d) Hydrocephalus
Which of the following is the most appropriate intervention for a child with a recent neurological injury who is showing signs of increased intracranial pressure?
a) Administer narcotic pain medications
b) Provide a quiet and darkened environment
c) Administer oral hydration
d) Encourage movement to assess neurological status
A 4-year-old child with a history of frequent falls and muscle weakness is diagnosed with muscular dystrophy. What is the typical progression of this condition?
a) Sudden onset of loss of motor function
b) Progressive loss of muscle strength, starting in the legs
c) Static motor function after early childhood
d) Rapid deterioration in cognitive function
Which of the following signs and symptoms is most commonly associated with a child diagnosed with a brain tumor?
a) Severe headache, nausea, vomiting, and irritability
b) Sudden weakness of the extremities
c) Seizures with loss of consciousness
d) Abnormal gait with no other symptoms
In a child with spina bifida, what is the most critical nursing intervention immediately after birth?
a) Place the infant in a prone position with a sterile dressing over the defect
b) Administer pain medications
c) Perform a neurological exam
d) Begin intravenous fluids
Which of the following conditions would most likely result in a positive Kernig’s sign in a child?
a) Brain tumor
b) Meningitis
c) Encephalitis
d) Seizure disorder
Which assessment finding would most strongly suggest a child is experiencing a seizure?
a) Loss of consciousness, jerking movements, and postictal confusion
b) Sudden loss of vision
c) Unilateral weakness and slurred speech
d) Loss of appetite and severe headache
In a child with a history of frequent, uncontrolled seizures, what is an essential teaching point for caregivers?
a) Use a weighted blanket during sleep
b) Administer anti-seizure medication at the same time every day
c) Restrict fluid intake to avoid seizures
d) Allow the child to engage in extreme physical activities
A 2-year-old child is brought in with a sudden onset of neck stiffness, fever, and irritability. What is the most likely diagnosis?
a) Stroke
b) Meningitis
c) Seizure disorder
d) Encephalitis
Which condition involves the loss of coordination and balance in a child and is often associated with an underlying genetic mutation?
a) Ataxia-telangiectasia
b) Multiple sclerosis
c) Epilepsy
d) Parkinson’s disease
What is a characteristic symptom of a child with absence seizures (petit mal seizures)?
a) Sudden loss of muscle tone
b) Brief episodes of staring and unresponsiveness
c) Jerking movements of the arms and legs
d) Loss of consciousness for more than 5 minutes
Which of the following is the most appropriate initial intervention for a child experiencing a status epilepticus seizure?
a) Administer oxygen and secure the airway
b) Insert a nasogastric tube
c) Administer anticonvulsant drugs immediately
d) Start intravenous fluids
A child with a neurological disorder is being monitored for developmental delays. Which of the following is a primary concern for the child’s caregivers?
a) Encouraging normal social development
b) Supporting motor function improvement through therapy
c) Educating the child on proper hygiene
d) Developing cognitive skills at the expense of socialization
Which of the following conditions would most likely cause a child to exhibit ataxia (uncoordinated movement) and slurred speech?
a) Guillain-Barré syndrome
b) Hydrocephalus
c) Stroke
d) Cerebellar ataxia
Which assessment finding would be most concerning in a child diagnosed with a brainstem injury?
a) Fever and vomiting
b) Abnormal pupillary response and respiratory irregularity
c) Seizures and loss of consciousness
d) Inability to move one side of the body
Which of the following is an appropriate intervention for a child with a recent head injury who is at risk for cerebral edema?
a) Restrict fluids
b) Maintain the head of the bed elevated to 30 degrees
c) Administer corticosteroids
d) Encourage frequent coughing and deep breathing
What is the typical clinical presentation of a child with a transient ischemic attack (TIA)?
a) Sudden onset of hemiparesis and visual disturbances
b) Loss of consciousness and generalized seizure activity
c) Sudden, severe headache with nausea
d) Dizziness and confusion lasting for several days
In the management of a child with encephalitis, what is the priority intervention?
a) Administration of antiviral medications
b) Seizure prophylaxis and monitoring for increased ICP
c) Surgical intervention to remove infected tissue
d) Placement of a shunt to prevent hydrocephalus
A child with a neurological condition develops sudden weakness in both legs. What should the nurse assess first?
a) Cardiovascular status and blood pressure
b) Musculoskeletal function and pain
c) Respiratory status and airway patency
d) Presence of fever and headache
A 5-year-old child with a history of repeated falls and difficulty running is suspected of having ataxic cerebral palsy. What is the most likely cause of this condition?
a) Genetic mutation leading to abnormal brain development
b) Intrauterine infection affecting the central nervous system
c) Lack of oxygen supply to the brain at birth
d) Trauma to the brain during early childhood
Which of the following interventions is essential for a child diagnosed with neurofibromatosis?
a) Regular monitoring for development of tumors or other complications
b) Frequent use of physical therapy to address motor delays
c) Administration of a high-fat, low-carb diet
d) Instructing parents to avoid vaccinations
Which neurological disorder is often associated with the development of both cognitive and motor symptoms, such as poor coordination and memory loss, in a child?
a) Huntington’s disease
b) Tay-Sachs disease
c) Rett syndrome
d) Myasthenia gravis
Which of the following is a common manifestation of an acute viral infection affecting the central nervous system in a child?
a) Sudden onset of fever, headache, and stiff neck
b) Persistent vomiting without nausea
c) Disorientation and confusion lasting for several months
d) Loss of sensation in the extremities
What is the first line of treatment for a child presenting with acute Guillain-Barré syndrome?
a) Intravenous immunoglobulin (IVIG)
b) Antibiotics for potential infection
c) Corticosteroids to reduce inflammation
d) Immediate surgery to decompress the spinal cord
A child is diagnosed with a seizure disorder and is prescribed carbamazepine. Which side effect would be most concerning for the nurse to monitor?
a) Weight gain and increased appetite
b) Drowsiness and difficulty concentrating
c) Rash and signs of infection
d) Increased thirst and frequent urination
A 9-year-old child presents with sudden weakness and difficulty speaking. What is the most urgent assessment to perform?
a) Assess the child for signs of stroke or transient ischemic attack (TIA)
b) Check for dehydration and electrolyte imbalance
c) Evaluate for an allergic reaction to food or medications
d) Assess for signs of head trauma and intracranial bleeding
What is a key feature of a child with a diagnosis of seizure disorder in terms of long-term management?
a) The child will eventually outgrow the disorder with age
b) Lifelong adherence to prescribed medications may be necessary
c) Seizure activity will always become more severe over time
d) The child should avoid any physical activity to reduce risk
A 2-year-old child is diagnosed with hydrocephalus. What is the most common initial sign of this condition?
a) Seizures
b) Enlarged head circumference
c) Weak cry
d) Poor feeding
Which of the following is the primary goal when managing a child with cerebral palsy?
a) Complete cure of motor deficits
b) Maximize independence and quality of life
c) Prevent seizures from occurring
d) Provide continuous bed rest for muscle recovery
A child with a neurological alteration is being prepared for a CT scan. What is an important pre-procedure teaching for the child’s parents?
a) The procedure will take several hours to complete.
b) The child will need to remain awake and still during the procedure.
c) The child will need to fast for at least 12 hours before the test.
d) The child will be given a sedative to help them relax during the procedure.
Which of the following is a characteristic symptom of a child with Duchenne muscular dystrophy?
a) Seizures with stiffening of the body
b) Difficulty walking and frequent falls
c) Severe headache and nausea
d) Sudden jerky movements in the arms and legs
Which finding would be most concerning in a child who has recently experienced a head injury?
a) Vomiting and persistent headache
b) Increased appetite and normal sleep patterns
c) Mild dizziness lasting for a few minutes
d) Mild irritability that resolves with rest
A child presents with fever, irritability, and a bulging fontanel. What is the most likely diagnosis?
a) Meningitis
b) Encephalitis
c) Cerebral palsy
d) Hydrocephalus
A child with suspected seizure disorder is brought to the emergency department. Which of the following is the priority intervention during a seizure?
a) Administer seizure medication immediately
b) Protect the child from injury and maintain airway patency
c) Obtain an EEG to confirm the seizure diagnosis
d) Encourage the child to sleep following the seizure
Which condition involves a sudden onset of paralysis in a child, typically following a viral infection?
a) Guillain-Barré syndrome
b) Myasthenia gravis
c) Amyotrophic lateral sclerosis
d) Multiple sclerosis
What is the primary concern when a child is diagnosed with a brain tumor?
a) Preventing seizures
b) Managing nausea and vomiting
c) Reducing intracranial pressure
d) Improving cognitive function
A child with a neurological disorder is admitted with increased intracranial pressure (ICP). Which sign would indicate worsening ICP?
a) Decreased heart rate
b) Hyperactivity
c) Widening pulse pressure
d) Decreased blood pressure
Which of the following is the most common cause of a seizure disorder in a child?
a) Meningitis
b) Epilepsy
c) Fever (febrile seizures)
d) Hydrocephalus
A 3-year-old child is diagnosed with a condition that leads to progressive weakness and difficulty walking. What condition should the nurse suspect?
a) Cerebral palsy
b) Muscular dystrophy
c) Epilepsy
d) Hydrocephalus
Which of the following is the most appropriate intervention for a child with spina bifida who is experiencing a urinary tract infection (UTI)?
a) Encourage frequent fluid intake and regular catheterization
b) Administer a high-protein diet to promote healing
c) Use a heating pad to alleviate abdominal pain
d) Restrict fluid intake to reduce urinary output
What is the hallmark sign of a child with Reye’s syndrome?
a) Sudden onset of a high fever and abdominal pain
b) Vomiting, confusion, and loss of consciousness following a viral infection
c) Prolonged muscle weakness and fatigue
d) Severe headaches and blurred vision
Which of the following is a typical finding in children with a diagnosis of hydrocephalus?
a) Headache and vomiting
b) Excessive drooling and lack of motor skills
c) Bulging fontanel and irritability
d) Poor appetite and decreased weight gain
A child with a suspected brain tumor is undergoing a CT scan. What is an important pre-procedure consideration?
a) The child must not eat or drink for 12 hours prior
b) The child will need to be sedated during the procedure
c) The procedure will take several days to complete
d) The child should be placed in a reclining position with a neck brace
What is a common long-term effect of untreated brain injuries in children?
a) Progressive loss of vision
b) Cognitive and developmental delays
c) Progressive motor weakness
d) Chronic pain syndrome
A child with Down syndrome presents with difficulty coordinating movements. What neurological condition might be suspected?
a) Cerebellar ataxia
b) Epilepsy
c) Hydrocephalus
d) Cerebral palsy
What is a significant complication in children with spina bifida that requires careful monitoring?
a) Sepsis and systemic infections
b) Loss of vision
c) Increased intracranial pressure
d) Gastrointestinal bleeding
Which type of seizure is characterized by jerking movements that affect the whole body?
a) Absence seizure
b) Tonic-clonic seizure
c) Myoclonic seizure
d) Atonic seizure
What is the most appropriate intervention for a child who is having a seizure?
a) Hold the child down to prevent injury
b) Place something in the child’s mouth to prevent biting
c) Place the child on their side to prevent aspiration
d) Administer oral fluids immediately after the seizure
A child with a neurological disorder develops a fever, stiff neck, and rash. What is the most likely diagnosis?
a) Meningitis
b) Epilepsy
c) Encephalitis
d) Guillain-Barré syndrome
Which condition is most commonly associated with developmental delay and a characteristic “duck-like” walk in children?
a) Muscular dystrophy
b) Cerebral palsy
c) Spina bifida
d) Guillain-Barré syndrome
Which condition is characterized by progressive muscle weakness and difficulty swallowing in a child?
a) Guillain-Barré syndrome
b) Duchenne muscular dystrophy
c) Multiple sclerosis
d) Huntington’s disease
Which of the following is the most common cause of a neurological alteration in children under the age of 5?
a) Genetic disorders
b) Infections such as meningitis
c) Head trauma
d) Congenital malformations
A child with a neurological disorder presents with a sudden loss of vision and is unable to move their left leg. What might this suggest?
a) Stroke
b) Epilepsy
c) Spina bifida
d) Multiple sclerosis
Which of the following is a key sign of meningitis in an infant?
a) Decreased appetite and irritability
b) Sudden weakness in the arms
c) High fever, bulging fontanel, and poor feeding
d) Loss of coordination
A child with a neurological alteration is prescribed a shunt to treat hydrocephalus. What should the nurse educate the parents about?
a) The shunt is a temporary device that will be removed after a year.
b) The child will need to undergo shunt revisions periodically as they grow.
c) The shunt will be flushed daily to prevent blockages.
d) The shunt will correct the neurological alteration completely.
Which condition is most commonly associated with developmental delays and abnormal muscle tone in children?
a) Cerebral palsy
b) Epilepsy
c) Meningitis
d) Hydrocephalus
A 5-year-old child with a recent brain injury presents with altered consciousness, confusion, and nausea. What should the nurse do first?
a) Administer an antiemetic
b) Obtain a CT scan of the head
c) Monitor vital signs every 4 hours
d) Encourage oral fluids
Which of the following is a hallmark sign of an infant with cerebral palsy?
a) Decreased muscle tone and poor feeding
b) Difficulty holding the head up and stiff arms or legs
c) Rapidly progressing loss of motor function
d) Weak cry and poor social interactions
Which of the following is the most appropriate intervention for a child who has experienced a traumatic brain injury (TBI)?
a) Apply ice to the head to reduce swelling
b) Monitor for signs of increased intracranial pressure (ICP)
c) Encourage movement and physical activity to prevent muscle stiffness
d) Administer medications for pain and fever without a doctor’s order
A child with spina bifida is at risk for which of the following complications?
a) Seizure disorder
b) Respiratory distress
c) Bladder and bowel dysfunction
d) Visual disturbances
Which neurological disorder is characterized by the degeneration of motor neurons, leading to muscle weakness and atrophy?
a) Amyotrophic lateral sclerosis (ALS)
b) Muscular dystrophy
c) Guillain-Barré syndrome
d) Epilepsy
A child with a neurological alteration is diagnosed with epilepsy. Which of the following should be included in the management plan?
a) Restrict the child’s physical activity completely
b) Keep a seizure diary to track frequency and triggers
c) Use a restrictive diet to control seizures
d) Discontinue all medications after 6 months if seizures stop
A 7-year-old child with a history of head trauma presents with a persistent headache and vomiting. What should the nurse suspect?
a) A concussion
b) Brain hemorrhage or increased intracranial pressure
c) Migraine
d) Epilepsy
What is the most likely cause of an episode of absent seizures in a child?
a) Hyperactivity or excitement
b) Underlying cerebral palsy
c) A sudden increase in body temperature
d) A brief disturbance in the brain’s electrical activity
Which neurological condition is associated with excessive daytime sleepiness and episodes of sudden sleep?
a) Narcolepsy
b) Epilepsy
c) Hydrocephalus
d) Parkinson’s disease
A child with a neurological alteration has been diagnosed with a brain tumor. Which of the following is a common symptom?
a) Sudden and severe headache
b) Sudden inability to walk
c) Slurred speech and facial drooping
d) Rapid breathing and shallow respirations
Which condition in a child is associated with a characteristic “butterfly” shaped rash on the face?
a) Systemic lupus erythematosus (SLE)
b) Duchenne muscular dystrophy
c) Myasthenia gravis
d) Guillain-Barré syndrome
A child with meningitis is at risk for which of the following complications?
a) Sepsis
b) Brain herniation
c) Hyperglycemia
d) Hypertension
Which intervention is most important when caring for a child with increased intracranial pressure (ICP)?
a) Administer antibiotics promptly to prevent infection
b) Keep the head of the bed elevated to 30 degrees
c) Encourage the child to sit up and engage in physical activity
d) Administer sedatives to prevent agitation
Which of the following would be the most appropriate first action for a nurse caring for a child with suspected Guillain-Barré syndrome?
a) Monitor for signs of respiratory distress and weakness
b) Begin physical therapy immediately
c) Administer an antibiotic to prevent infection
d) Perform a lumbar puncture to confirm diagnosis
Which of the following is a typical sign of a seizure in a child?
a) Rapid, involuntary movements of one limb
b) Stiffening of the body followed by jerking movements
c) Sudden loss of consciousness with no muscle activity
d) Persistent crying and restlessness
Which intervention should be included in the care plan for a child diagnosed with hydrocephalus and a ventriculoperitoneal (VP) shunt?
a) Administer high-dose diuretics to reduce cerebral edema
b) Educate the family on recognizing signs of shunt infection or malfunction
c) Provide total bed rest to prevent increased ICP
d) Restrict fluid intake to prevent increased fluid buildup in the brain
A child is diagnosed with an infection that has caused increased intracranial pressure (ICP). Which of the following is the most appropriate action?
a) Administer IV fluids rapidly to reduce pressure
b) Keep the child in a supine position to encourage rest
c) Monitor neurological status frequently for changes in consciousness
d) Encourage frequent coughing and deep breathing to clear the airways
A child with epilepsy is receiving anti-seizure medication. Which of the following is important to monitor?
a) Regular blood glucose levels
b) Therapeutic drug levels to ensure effectiveness and safety
c) Height and weight to monitor for nutritional deficiencies
d) Blood pressure and respiratory rate
Which of the following conditions is characterized by delayed development of motor skills and muscle weakness, usually in early childhood?
a) Duchenne muscular dystrophy
b) Cerebral palsy
c) Reye’s syndrome
d) Hydrocephalus
Which assessment finding would most likely suggest the need for further investigation in a child with a neurological alteration?
a) Difficulty moving the left arm and leg
b) Complaints of feeling fatigued after physical activity
c) Absence of reflexes in both lower extremities
d) Frequent headaches and a stiff neck
What is the most important safety consideration when caring for a child with epilepsy?
a) Ensuring a quiet, dark room to prevent seizure triggers
b) Keeping the child away from all physical activity
c) Preventing the child from being left alone during seizures
d) Encouraging frequent hydration to prevent dehydration
A child with a neurological disorder presents with difficulty speaking and poor muscle coordination. Which condition should the nurse suspect?
a) Multiple sclerosis
b) Huntington’s disease
c) Cerebral palsy
d) Duchenne muscular dystrophy
Which of the following interventions is most appropriate for a child with a severe head injury and signs of increased intracranial pressure (ICP)?
a) Place the child in a low Fowler’s position
b) Avoid suctioning and minimize environmental stimuli
c) Encourage deep breathing and coughing exercises
d) Elevate the legs to improve circulation
A child diagnosed with Guillain-Barré syndrome is experiencing progressive weakness. What is the most important nursing intervention?
a) Begin physical therapy to improve mobility
b) Monitor respiratory function closely for signs of respiratory failure
c) Encourage the child to eat a high-protein diet
d) Administer corticosteroids to reduce inflammation
What is the primary goal of treatment for a child with hydrocephalus?
a) Prevent seizures
b) Prevent complications such as increased intracranial pressure
c) Reduce the risk of infection in the brain
d) Promote normal developmental milestones
Which condition in a child is commonly associated with an abnormal gait and difficulty with fine motor skills?
a) Cerebral palsy
b) Down syndrome
c) Spina bifida
d) Seizure disorder
A child with a neurological alteration is being treated for an infection of the central nervous system. What is the priority nursing action?
a) Administer broad-spectrum antibiotics as prescribed
b) Monitor for signs of increased intracranial pressure (ICP)
c) Provide comfort measures to alleviate pain
d) Encourage oral fluids to prevent dehydration
Which of the following signs and symptoms would be consistent with a seizure in a child?
a) Inability to move the arms and legs
b) Loss of consciousness with rhythmic jerking movements
c) Sudden loss of vision without any other symptoms
d) Unexplained headache and dizziness
A 6-month-old infant is diagnosed with congenital hydrocephalus. Which of the following signs should the nurse monitor for?
a) Increased head circumference
b) Tense or bulging fontanels
c) Excessive crying and irritability
d) All of the above
Which of the following conditions is most likely to cause motor weakness in a child after a viral infection?
a) Guillain-Barré syndrome
b) Spinal cord injury
c) Hydrocephalus
d) Cerebral palsy
A child with a neurological alteration is at risk for aspiration. What intervention should be included in the care plan?
a) Position the child with the head elevated to prevent aspiration
b) Encourage the child to drink fluids quickly to promote swallowing
c) Restrict all oral intake to prevent choking
d) Feed the child while lying flat to facilitate digestion
A child with a seizure disorder is on antiepileptic drugs. Which of the following is a common side effect of these medications?
a) Hypertension
b) Drowsiness and dizziness
c) Hyperactivity
d) Weight loss
A child is diagnosed with a neurogenic bladder due to a spinal cord injury. What is an appropriate intervention?
a) Monitor for urinary retention and encourage regular voiding
b) Administer diuretics to promote urine output
c) Encourage the child to increase fluid intake to dilute the urine
d) Limit fluid intake to prevent overloading the bladder
A child with a brain tumor is experiencing increased intracranial pressure (ICP). Which of the following symptoms is most likely to occur?
a) High fever and vomiting
b) Nausea, headache, and a decline in consciousness
c) Seizures and dizziness
d) Rapid eye movement and hearing loss
Which of the following is the most likely cause of developmental delays in a child with a history of prematurity and intraventricular hemorrhage (IVH)?
a) Brain damage due to inadequate oxygen supply
b) Genetic defects causing motor dysfunction
c) Infection leading to severe developmental setbacks
d) Environmental factors such as lack of stimulation
Which of the following is most important for the nurse to assess in a child suspected of having a neurological alteration due to trauma?
a) Presence of vomiting and difficulty waking
b) Loss of appetite and refusal to eat
c) Increased urinary output and fatigue
d) Pain localized to one extremity
A child with spina bifida is experiencing bladder dysfunction. What is the most appropriate nursing intervention?
a) Monitor for signs of urinary tract infections (UTIs)
b) Encourage the child to drink large amounts of water
c) Teach the child to self-catheterize if appropriate
d) All of the above
A child with epilepsy is being taught about seizure precautions. What should the nurse include in the teaching plan?
a) Keep a clear airway during a seizure
b) Avoid placing anything in the child’s mouth during a seizure
c) Never restrain the child during a seizure
d) All of the above
A child diagnosed with a brain injury is exhibiting signs of increasing irritability, confusion, and slurred speech. What is the most likely cause?
a) Hypoglycemia
b) Increased intracranial pressure
c) Infection
d) Dehydration
Which of the following is a common neurological symptom of lead poisoning in children?
a) Hyperactivity and impulsivity
b) Severe headaches and vomiting
c) Developmental delays and cognitive impairment
d) Sudden vision loss
A child with a neurological alteration is at risk for sleep disturbances. What intervention should be included in the care plan?
a) Encourage a quiet, dark environment before bedtime
b) Administer sedatives to induce sleep
c) Allow the child to stay awake during the day to increase sleep at night
d) Limit physical activity during the day to prevent exhaustion
A child with a neurological alteration is being treated with steroids. What side effect should the nurse monitor for?
a) Hypoglycemia
b) Increased appetite and weight gain
c) Hyperthermia
d) Hypotension
Which of the following is a common sign of a brain injury in a child?
a) Sudden changes in mood and behavior
b) Prolonged fever and coughing
c) Persistent low blood pressure
d) Excessive crying without cause
A child diagnosed with a spinal cord injury is experiencing paralysis. Which intervention should the nurse prioritize?
a) Provide physical therapy to improve strength
b) Monitor for complications such as pressure ulcers and urinary retention
c) Encourage the child to participate in team sports
d) Administer pain medication on a scheduled basis
A child with neurofibromatosis presents with a new skin lesion. What is the most appropriate action by the nurse?
a) Monitor the lesion for any changes in size or appearance
b) Administer an analgesic to relieve pain
c) Refer the child for genetic counseling
d) Ensure the child is protected from direct sunlight
Which of the following signs would most likely indicate a neurological emergency in a child?
a) Loss of consciousness and inability to awaken
b) Sudden weight loss and poor appetite
c) Excessive salivation and dry mouth
d) Increased physical activity and restlessness
A child is being treated for a seizure disorder and is prescribed phenytoin. Which of the following instructions should the nurse include when teaching the child’s parents?
a) “Ensure the child takes this medication with food.”
b) “Monitor the child’s blood pressure regularly.”
c) “Increase the dose if the child misses a dose.”
d) “You may stop the medication once seizures are controlled.”
Which clinical manifestation is most likely seen in a child with an epidural hematoma following a head injury?
a) Loss of consciousness followed by a brief period of lucidity
b) Sudden onset of seizures
c) Progressive weakness and fatigue
d) Increased intracranial pressure with vomiting
A 3-year-old child presents with weakness, muscle atrophy, and difficulty swallowing. What is the most likely diagnosis?
a) Duchenne muscular dystrophy
b) Amyotrophic lateral sclerosis
c) Spinal muscular atrophy
d) Cerebral palsy
Which of the following assessments is a priority for a child who has suffered a traumatic brain injury and is experiencing signs of increased intracranial pressure (ICP)?
a) Monitoring urine output and hydration status
b) Assessing vital signs and neurological status frequently
c) Assessing the child’s skin for signs of pressure ulcers
d) Providing comfort measures to reduce anxiety
A nurse is caring for a child diagnosed with a brain tumor. Which sign should prompt the nurse to immediately notify the healthcare provider?
a) Headache and vomiting in the morning
b) Occasional lethargy and irritability
c) Loss of appetite and slight fever
d) Worsening coordination and unsteady gait
Which of the following conditions is associated with a loss of motor function in a child following a viral infection?
a) Multiple sclerosis
b) Guillain-Barré syndrome
c) Hydrocephalus
d) Spinal cord injury
A child with a spinal cord injury is at risk for autonomic dysreflexia. Which of the following should the nurse immediately do if signs of autonomic dysreflexia develop?
a) Place the child in a Trendelenburg position
b) Remove any tight clothing or objects that may be irritating the skin
c) Administer a dose of epinephrine
d) Perform deep suctioning to open the airway
A child diagnosed with cerebral palsy exhibits spasticity. Which of the following interventions would most likely be used to reduce muscle tightness?
a) High-dose corticosteroids
b) Muscle relaxants and physical therapy
c) Antidepressants
d) Intravenous hydration therapy
Which of the following interventions is a priority for a child with a severe head injury and suspected increased intracranial pressure (ICP)?
a) Initiate intravenous fluids to maintain hydration
b) Keep the child in a quiet, dark environment
c) Position the child with the head of the bed flat
d) Apply a cooling blanket to prevent fever
A 5-year-old child is diagnosed with a herniated disk causing a neurological alteration. What is the most important aspect of care?
a) Providing pain management and positioning for comfort
b) Encouraging participation in physical activities
c) Teaching the child and parents about spinal surgery options
d) Limiting mobility to prevent further injury
A child with a spinal cord injury is experiencing urinary retention. What is the most appropriate nursing intervention?
a) Provide regular catheterization to promote bladder emptying
b) Restrict fluid intake to prevent urinary overflow
c) Encourage frequent fluid intake to stimulate bladder activity
d) Monitor for signs of urinary tract infections (UTIs) only
Which of the following is a key symptom of a chiari malformation in a child?
a) Seizures
b) Progressive headache, nausea, and dizziness
c) Blurred vision and photosensitivity
d) Slurred speech and drooping eyelid
A 10-year-old child with cerebral palsy has difficulty with fine motor skills. Which of the following interventions would best assist with this child’s daily activities?
a) Teaching the child to walk without assistance
b) Encouraging the use of assistive devices to enhance function
c) Focusing only on motor skills related to gross movements
d) Limiting the child’s independence to reduce frustration
A child with a recent spinal cord injury is exhibiting signs of respiratory distress. Which of the following interventions should be prioritized?
a) Administer oxygen and prepare for intubation if necessary
b) Position the child in a high Fowler’s position to enhance breathing
c) Increase fluid intake to promote lung expansion
d) Perform chest physiotherapy to clear secretions
Which of the following is the most common cause of hydrocephalus in infants?
a) Intrauterine infections
b) Premature birth
c) Brain tumor
d) Spinal cord injury
A child diagnosed with neurofibromatosis is being monitored for complications. Which of the following is the most serious concern?
a) Development of skin lesions and tumors
b) Progressive hearing loss and balance issues
c) Hydrocephalus or increased intracranial pressure
d) Spinal deformities such as scoliosis
A child with a brain injury presents with increased lethargy and irritability. Which of the following is the priority nursing action?
a) Provide pain relief and offer comfort measures
b) Assess the child’s neurological status and vital signs
c) Administer sedatives as prescribed
d) Encourage the child to drink fluids
Which of the following interventions would be most appropriate for a child with a neurogenic bladder due to a spinal cord injury?
a) Teach the child to perform intermittent self-catheterization
b) Encourage the child to take diuretics to increase urine output
c) Restrict fluid intake to prevent urinary overflow
d) Perform catheterization only if urinary retention occurs
A child with a traumatic brain injury is being monitored for signs of increasing intracranial pressure (ICP). Which of the following would be considered an early sign of ICP in children?
a) Bradycardia
b) Vomiting and headache
c) High fever and seizures
d) Decreased responsiveness and pupil dilation
Which of the following is the most common neurological symptom in children with traumatic brain injuries (TBI)?
a) Decreased level of consciousness
b) Sudden loss of vision
c) Uncontrolled seizures
d) Paralysis of one side of the body
A child diagnosed with a brain tumor has undergone surgery. What is the most important consideration during the post-operative period?
a) Assessing for signs of infection at the surgical site
b) Monitoring for signs of increased intracranial pressure (ICP)
c) Promoting early ambulation to prevent complications
d) Administering pain medication as prescribed
A child with a seizure disorder is having frequent absence seizures. What is the most appropriate treatment for this type of seizure?
a) Anticonvulsant medications, such as ethosuximide or valproic acid
b) Surgical removal of the brain tissue causing the seizures
c) Administration of corticosteroids to reduce inflammation
d) Immediate emergency intervention to prevent status epilepticus
A child with a neurological disorder presents with a sudden onset of weakness in the arms and legs, difficulty breathing, and absent reflexes. What is the most likely diagnosis?
a) Guillain-Barré syndrome
b) Duchenne muscular dystrophy
c) Spinal muscular atrophy
d) Cerebral palsy
A 6-year-old child with spina bifida is showing signs of a UTI. What should the nurse monitor for in this child?
a) Fever and irritability
b) Decreased appetite and fatigue
c) Increased spinal pain and muscle weakness
d) Difficulty with bowel movements
A nurse is caring for a child with a history of cerebral palsy. Which of the following assessments should be done regularly?
a) Assessing for signs of dehydration
b) Monitoring growth and development milestones
c) Checking for pressure ulcers and skin breakdown
d) Measuring urine output
A 4-year-old child is brought to the emergency room after a head injury. Which of the following is a priority nursing intervention?
a) Assessing for signs of increased intracranial pressure (ICP)
b) Administering pain medication
c) Reassuring the parents
d) Checking for broken bones
A child with cerebral palsy has increased muscle tone and spasticity. Which of the following interventions would be most effective in managing this symptom?
a) Physical therapy and muscle relaxants
b) High doses of corticosteroids
c) Using a cane or walker for assistance
d) Avoiding movement to reduce muscle strain
A 7-year-old child is diagnosed with a brain tumor. What is the most significant complication that the nurse should monitor for during the child’s treatment?
a) Seizures
b) Weight loss
c) Infection
d) Increased intracranial pressure (ICP)
A child with Guillain-Barré syndrome presents with ascending paralysis. What is the priority nursing action?
a) Monitor respiratory function closely
b) Provide pain management
c) Encourage mobility to improve circulation
d) Administer immunoglobulin therapy
A child with spina bifida has developed a urinary tract infection (UTI). What should the nurse focus on when providing care?
a) Administering antibiotics as prescribed
b) Encouraging the child to drink more fluids
c) Monitoring the child’s neurological status
d) Assessing for skin breakdown
Which of the following is a typical sign of increased intracranial pressure (ICP) in a child?
a) Bradycardia and hypertension
b) Hypothermia and dry skin
c) Hyperactivity and insomnia
d) Frequent urination and excessive thirst
What is the most common cause of seizures in a child with a recent history of a high fever?
a) Meningitis
b) Febrile seizures
c) Epilepsy
d) Head injury
A 5-year-old child is being treated for hydrocephalus. Which of the following should the nurse monitor closely?
a) Blood glucose levels
b) Respiratory rate and effort
c) Head circumference and signs of ICP
d) Electrolyte balance
A child with a traumatic brain injury (TBI) is unresponsive, and the nurse notices the child’s pupils are dilated and non-reactive. What should the nurse do first?
a) Assess for the presence of a pulse
b) Position the child in a lateral decubitus position
c) Notify the healthcare provider immediately
d) Administer intravenous fluids
Which of the following is a priority intervention for a child who has experienced a seizure?
a) Insert an oral airway to maintain airway patency
b) Place the child on their back with a pillow under their head
c) Move any objects that could cause injury away from the child
d) Administer seizure medications immediately
A child with a spinal cord injury is experiencing autonomic dysreflexia. Which of the following is the most appropriate initial nursing intervention?
a) Increase fluid intake to promote diuresis
b) Sit the child upright and remove any constricting clothing
c) Administer a vasopressor to manage blood pressure
d) Perform deep suctioning to clear secretions
A child with a neurological condition is experiencing difficulty swallowing. Which of the following interventions would be appropriate?
a) Offer small, frequent meals of soft, thickened foods
b) Encourage the child to drink thin liquids
c) Restrict oral intake and use only enteral feeding
d) Provide chewing gum to stimulate swallowing
A child with spina bifida has developed hydrocephalus. What is the most appropriate treatment for this condition?
a) Administer diuretics to reduce fluid build-up
b) Insert a ventriculoperitoneal (VP) shunt
c) Initiate physical therapy to strengthen muscles
d) Perform a lumbar puncture to drain excess fluid
Essay Questions And Answers For Study Guide
Discuss the pathophysiology, clinical manifestations, and nursing interventions for a child with cerebral palsy.
Answer:
Pathophysiology: Cerebral palsy (CP) is a group of disorders that affect movement, muscle tone, and motor skills due to non-progressive brain injury during early development. This damage usually occurs before, during, or shortly after birth. The most common causes are premature birth, birth asphyxia, and infections or brain hemorrhages. CP results in brain lesions that impair motor control and coordination, often leading to spasticity, rigidity, and involuntary movements.
Clinical Manifestations: Symptoms of CP vary depending on the severity and type of brain injury. Common signs include:
- Muscle stiffness (spasticity) or weakness
- Difficulty with balance and coordination (ataxia)
- Delayed motor development, such as trouble crawling, walking, or speaking
- Abnormal gait or posture
- Seizures (in some cases)
- Intellectual disabilities (present in some children with CP)
Nursing Interventions: Nursing care for children with cerebral palsy is multidisciplinary and aims to improve mobility, independence, and quality of life. Key interventions include:
- Physical Therapy: Helps with muscle stretching, strengthening, and improving coordination.
- Medications: Muscle relaxants like baclofen can reduce spasticity. Anti-seizure medications are prescribed if seizures occur.
- Surgical Interventions: In some cases, surgery is necessary to release tight muscles or correct bone deformities.
- Support for Families: Nurses provide education on positioning, feeding techniques, and coping strategies. Counseling may also be necessary to support families in managing the emotional and practical aspects of care.
Analyze the complications, clinical management, and nursing care for a child with hydrocephalus.
Answer:
Complications: Hydrocephalus is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain. If untreated, it can lead to increased intracranial pressure (ICP), brain damage, and developmental delays. Common complications include:
- Increased ICP: This can cause headaches, vomiting, and decreased level of consciousness.
- Neurological deficits: Long-term hydrocephalus can lead to motor dysfunction, cognitive delays, or vision problems.
- Shunt malfunction: The most common complication is the failure of the ventriculoperitoneal (VP) shunt used to drain excess CSF, leading to infection or blockage.
Clinical Management: Management of hydrocephalus primarily involves surgery to implant a ventriculoperitoneal (VP) shunt, which drains excess CSF from the brain to the abdomen. The shunt may need to be adjusted or replaced as the child grows. Other treatments include:
- Monitoring ICP: Frequent neurochecks and monitoring for signs of shunt malfunction or infection are essential.
- Managing Shunt Complications: If the shunt becomes infected or blocked, surgical revision may be required.
Nursing Care: Nurses play a critical role in monitoring the child’s neurological status and educating the family:
- ICP Monitoring: Nurses must assess for signs of increased ICP, including changes in the child’s behavior, irritability, or lethargy.
- Post-operative Care: Following shunt placement, nurses must monitor for infection, ensure the child’s head remains elevated, and assess for signs of leakage or blockage.
- Family Education: Nurses educate families on how to care for the shunt, recognize complications, and understand the child’s long-term care needs.
Explain the pathophysiology, treatment options, and nursing considerations for a child with a spinal cord injury.
Answer:
Pathophysiology: Spinal cord injuries (SCI) in children often result from trauma such as accidents, falls, or violence. The injury can cause temporary or permanent damage to the spinal cord, leading to loss of motor and sensory function below the level of injury. The severity of the injury depends on the location of the damage and whether the cord is partially or completely severed. In children, the developing spine and musculoskeletal system may make them more susceptible to specific patterns of injury compared to adults.
Treatment Options:
- Acute Management: The initial treatment for SCI includes immobilization to prevent further injury, stabilization of vital signs, and maintaining airway and respiratory function.
- Surgical Intervention: Surgery may be necessary to relieve pressure on the spinal cord, stabilize the spine, and remove any foreign objects or debris.
- Pharmacologic Treatment: High-dose corticosteroids may be given to reduce inflammation and prevent further injury to nerve cells.
- Rehabilitation: The focus of rehabilitation is to maximize physical function, improve independence, and support the psychological well-being of the child and family. This may include physical therapy, occupational therapy, and psychological counseling.
Nursing Considerations:
- Neurological Monitoring: Nurses should perform frequent neurological assessments to evaluate motor and sensory function and detect complications.
- Prevention of Complications: Nurses must monitor for complications such as pressure ulcers, deep vein thrombosis, urinary tract infections, and respiratory infections.
- Psychosocial Support: Adjusting to a spinal cord injury can be emotionally challenging. Nurses should provide psychological support, including helping families cope with the transition and loss of function.
- Family Education: Nurses should educate the family on skin care, physical therapy exercises, bowel and bladder management, and the potential long-term needs of the child.
Discuss the clinical management and nursing interventions for a child with a seizure disorder.
Answer:
Clinical Management: Seizure disorders in children, such as epilepsy, are typically managed with medications, lifestyle adjustments, and, in some cases, surgical intervention. The goals of treatment are to reduce the frequency and severity of seizures and to allow the child to lead a normal life.
- Medications: Antiepileptic drugs (AEDs), such as phenytoin, valproate, or levetiracetam, are commonly used. The choice of medication depends on the type of seizures and the child’s response to the drug.
- Ketogenic Diet: In children who do not respond to medications, a ketogenic diet may be prescribed to help control seizures. This high-fat, low-carbohydrate diet alters the brain’s energy metabolism.
- Surgical Treatment: In refractory cases, surgery may be considered to remove the area of the brain causing seizures or to implant a vagus nerve stimulator (VNS) to help control seizures.
Nursing Interventions:
- Seizure Precautions: Nurses should implement safety measures to protect the child during a seizure, including ensuring that the child is in a safe environment, positioning them on their side to prevent aspiration, and avoiding placing anything in their mouth.
- Medication Adherence: Nurses must educate parents on the importance of administering AEDs regularly and ensuring the child attends follow-up appointments to monitor drug levels and side effects.
- Monitoring for Side Effects: Nurses should be aware of the potential side effects of AEDs, such as drowsiness, dizziness, or gastrointestinal disturbances, and educate families on these concerns.
- Psychosocial Support: Seizure disorders can impact a child’s social interactions, schooling, and overall development. Nurses should support the family emotionally and provide resources for school accommodations and peer education.
What are the nursing care considerations and treatment options for a child diagnosed with Guillain-Barré syndrome?
Answer:
Pathophysiology: Guillain-Barré syndrome (GBS) is an autoimmune disorder where the immune system attacks the peripheral nerves, leading to ascending paralysis. It often follows a viral infection, such as a respiratory or gastrointestinal infection. The exact cause is unknown, but the body’s immune response mistakenly damages the myelin sheath, which impairs nerve conduction.
Treatment Options:
- Plasmapheresis (Plasma Exchange): This process removes harmful antibodies from the bloodstream and can help reduce the severity of the condition, particularly if started early in the disease process.
- Intravenous Immunoglobulin (IVIG): This is another treatment option that involves infusing antibodies from donated blood to help modulate the immune response.
- Supportive Care: This includes managing respiratory function, pain relief, and physical therapy to assist with recovery.
Nursing Care Considerations:
- Respiratory Monitoring: Because GBS can affect the respiratory muscles, nurses must closely monitor the child’s respiratory status, including vital signs and oxygen saturation levels.
- Pain Management: Children with GBS often experience significant pain due to nerve damage. Nurses should assess pain levels regularly and provide appropriate pain relief measures.
- Mobility Support: Physical therapy is essential to help the child regain strength and motor function as the condition improves.
- Family Education: Nurses need to educate families about the course of the disease, treatment options, and the importance of supportive care, including feeding and respiratory management.
Describe the causes, symptoms, and nursing management of a child with a head injury.
Answer:
Causes: Head injuries in children are most commonly caused by falls, motor vehicle accidents, sports injuries, and abuse. The immature skull and brain of young children make them more susceptible to trauma. Brain injuries can range from mild concussions to more severe injuries, including contusions and traumatic brain injuries (TBI).
Symptoms: The symptoms of a head injury in children depend on the severity of the injury. Common signs and symptoms include:
- Mild injuries (Concussion): Headache, dizziness, nausea, confusion, and irritability.
- Moderate to Severe Injuries: Loss of consciousness, seizures, unequal pupil dilation, persistent vomiting, difficulty waking up, and changes in behavior or cognition.
Nursing Management: Nursing care for a child with a head injury focuses on monitoring neurological status, preventing further injury, and managing symptoms:
- Initial Assessment: Perform a thorough neurological assessment to check for signs of increased intracranial pressure (ICP), including changes in consciousness, pupil reaction, and motor responses.
- Monitoring for ICP: Monitor vital signs, level of consciousness, and assess for signs of deteriorating neurological function.
- Pain Management: Provide pain relief and avoid medications like aspirin, which can increase the risk of bleeding.
- Education and Support: Educate the family on the importance of follow-up care, signs of deterioration, and when to seek medical help.
Discuss the pathophysiology, clinical presentation, and nursing care for a child with meningitis.
Answer:
Pathophysiology: Meningitis is an inflammation of the meninges, the protective membranes covering the brain and spinal cord. It can be caused by bacteria, viruses, or fungi. Bacterial meningitis is often more severe and requires immediate treatment. The infection leads to an inflammatory response, causing swelling, increased intracranial pressure, and potential brain damage. The most common bacterial causes include Neisseria meningitidis and Streptococcus pneumoniae.
Clinical Presentation: Symptoms of meningitis in children may include:
- Fever
- Headache
- Neck stiffness
- Photophobia
- Nausea and vomiting
- Seizures
- Changes in mental status, such as confusion, irritability, or lethargy
- In infants, symptoms may include bulging fontanels, poor feeding, and a high-pitched cry.
Nursing Care:
- Assessment: Nurses should monitor vital signs, neurological status, and level of consciousness closely.
- Antibiotic Therapy: Administer antibiotics as ordered, usually intravenously, for bacterial meningitis. Ensure that the correct dose and timing are adhered to.
- Hydration and Electrolyte Balance: Monitor fluid balance and ensure the child is hydrated. IV fluids may be required to manage dehydration and electrolyte imbalances.
- Isolation: In bacterial meningitis, implement isolation precautions to prevent the spread of infection, especially for meningococcal meningitis.
- Pain and Fever Management: Provide analgesics and antipyretics to manage headache and fever. Avoid overuse of aspirin in children due to the risk of Reye’s syndrome.
Explain the pathophysiology and management of a child with a stroke, including key nursing interventions.
Answer:
Pathophysiology: A stroke in children, also known as pediatric cerebrovascular accident (CVA), occurs when blood flow to the brain is disrupted, either by a blockage or hemorrhage. This disruption leads to oxygen deprivation, which can cause brain cell death and neurological deficits. Causes of stroke in children include congenital heart defects, sickle cell disease, infections, and trauma.
Symptoms: Signs and symptoms of a stroke in children include:
- Sudden weakness or numbness on one side of the body
- Difficulty speaking or understanding speech
- Vision changes
- Sudden severe headache
- Seizures
- Loss of coordination or balance
- Altered consciousness
Management: Management of pediatric stroke includes both acute and long-term treatment:
- Acute Treatment: In the emergency setting, the priority is to restore blood flow to the brain. For ischemic strokes, thrombolytics may be used to dissolve clots. For hemorrhagic strokes, surgical intervention may be needed to stop bleeding and reduce pressure on the brain.
- Neuroprotective Agents: Medications such as anticonvulsants are administered to prevent seizures that may result from brain injury.
- Rehabilitation: Physical, speech, and occupational therapies are essential for helping the child regain function and improve quality of life.
Nursing Interventions:
- Neurological Assessment: Nurses should conduct frequent neurological assessments, including checking for changes in consciousness, motor function, and sensory responses.
- Seizure Precautions: Ensure safety and monitor for seizures. Provide anticonvulsant therapy if necessary.
- Family Education: Teach the family about the potential long-term effects of a stroke and the importance of rehabilitation.
- Preventing Complications: Monitor for complications such as deep vein thrombosis (DVT), respiratory issues, or aspiration.
Evaluate the pathophysiology, clinical signs, and nursing interventions for a child with epilepsy.
Answer:
Pathophysiology: Epilepsy is a neurological disorder characterized by recurrent seizures caused by abnormal electrical discharges in the brain. Seizures can be focal (starting in one part of the brain) or generalized (affecting both hemispheres of the brain). The exact cause of epilepsy can vary, including genetic factors, brain injury, infections, or metabolic disorders. In some cases, the cause remains unknown.
Clinical Signs:
- Generalized Seizures: Include tonic-clonic (grand mal) seizures, characterized by muscle rigidity followed by rhythmic jerking movements, loss of consciousness, and incontinence.
- Focal Seizures: May involve jerking or twitching in one limb or part of the body, altered sensations, and altered consciousness.
- Absence Seizures: Characterized by brief lapses in awareness, staring spells, or subtle movements like blinking or lip-smacking.
Nursing Interventions:
- Seizure Precautions: Ensure a safe environment for the child during a seizure. Place the child on their side, clear the area of hard objects, and monitor airway patency.
- Medication Administration: Administer anti-epileptic drugs (AEDs) as prescribed. Monitor for side effects such as drowsiness or dizziness.
- Patient and Family Education: Educate the family about the nature of epilepsy, the importance of medication adherence, and how to respond to seizures.
- Monitoring and Documentation: Nurses should document the duration, type, and frequency of seizures. This information helps guide treatment adjustments.
- Emotional Support: Children with epilepsy may experience anxiety, depression, or social challenges. Nurses should provide emotional support and refer families to counseling or support groups.
Describe the causes, symptoms, and nursing interventions for a child with a brain tumor.
Answer:
Causes: Brain tumors in children can be either benign or malignant and may arise from brain cells or metastasize from other areas of the body. The exact cause of brain tumors is unknown, but genetic mutations, exposure to radiation, or family history of certain cancers can increase the risk.
Symptoms: Common signs of brain tumors in children include:
- Headaches, often worse in the morning or upon waking
- Vomiting, especially in the morning
- Seizures
- Neurological deficits, such as weakness, difficulty walking, or speech problems
- Changes in behavior or cognition
- Bulging fontanels in infants or toddlers
Nursing Interventions:
- Monitoring Neurological Status: Conduct frequent neurological assessments to detect changes in the child’s condition, including assessing for signs of increased intracranial pressure (ICP).
- Post-Operative Care: After surgery, ensure that the child’s vital signs are stable and monitor for complications such as infection or cerebral edema.
- Pain Management: Administer prescribed pain medications and monitor for side effects such as sedation or constipation.
- Family Support and Education: Provide emotional support and help families understand the treatment process. Provide education on managing post-surgical care, medication schedules, and follow-up appointments.
Discuss the role of the nurse in the assessment and care of a child with hydrocephalus.
Answer:
Pathophysiology: Hydrocephalus is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain, leading to increased intracranial pressure. This can result from an obstruction in the flow of CSF, impaired absorption, or an overproduction of CSF. In infants, hydrocephalus is often congenital, while in older children, it may be acquired due to infection, trauma, or tumors.
Clinical Signs: Signs and symptoms of hydrocephalus vary by age and the extent of the condition. In infants, signs include:
- Enlarged head size (due to increased fluid buildup)
- Bulging fontanels
- Poor feeding and irritability
- Vomiting and lethargy
- High-pitched cry In older children, symptoms may include:
- Headache
- Nausea and vomiting
- Papilledema (swelling of the optic nerve)
- Cognitive or developmental delays
Nursing Assessment and Care:
- Head Circumference Monitoring: In infants, regularly measure the head circumference to detect early signs of hydrocephalus.
- Neurological Assessments: Perform frequent neurological assessments, including checking for changes in consciousness, pupil response, and motor function.
- Surgical Interventions: Most children with hydrocephalus require surgery to relieve the pressure. A common treatment is the placement of a ventriculoperitoneal (VP) shunt to drain excess fluid from the brain to the abdomen.
- Post-operative Care: After shunt placement, monitor for signs of infection, shunt malfunction, or complications. Assess for signs of increased intracranial pressure (ICP), such as vomiting, headache, or altered mental status.
- Education: Educate the family on the signs of shunt infection or malfunction, and the importance of follow-up visits for monitoring the child’s condition.
What is the pathophysiology, clinical presentation, and nursing management for a child with cerebral palsy?
Answer:
Pathophysiology: Cerebral palsy (CP) refers to a group of neurological disorders that affect movement, posture, and muscle coordination. It is caused by brain damage that occurs during fetal development or early childhood, often before, during, or shortly after birth. The damage affects the areas of the brain that control muscle movements and coordination. Common causes of CP include prematurity, lack of oxygen during birth, infections, or brain trauma.
Clinical Presentation: The clinical manifestations of CP depend on the severity and type of brain damage. Common signs include:
- Spasticity: Muscle stiffness and exaggerated reflexes
- Athetosis: Involuntary, writhing movements
- Ataxia: Lack of coordination or balance
- Motor delays: Difficulty with sitting, walking, or performing fine motor skills
- Speech and swallowing difficulties: Some children may also experience issues with speech or feeding.
Nursing Management:
- Assessment: Nurses should conduct thorough developmental and neurological assessments to track motor skills and identify early signs of CP.
- Physical and Occupational Therapy: Collaborate with physiotherapists and occupational therapists to help improve mobility, strength, and daily living skills.
- Medications: Administer medications like baclofen or diazepam to manage spasticity. Botox injections may also be used to reduce muscle tightness.
- Surgical Interventions: In severe cases, surgery to correct musculoskeletal issues or improve range of motion may be necessary.
- Family Education and Support: Teach the family how to manage symptoms, provide a safe home environment, and encourage the child’s independence in daily activities.
Examine the causes, symptoms, and nursing interventions for a child with a seizure disorder.
Answer:
Causes: Seizures in children may be caused by a variety of factors, including:
- Genetic predisposition: Certain inherited conditions, like epilepsy, can increase the likelihood of seizures.
- Brain injury or infection: Trauma, meningitis, or encephalitis can lead to seizures.
- Metabolic disorders: Hypoglycemia or electrolyte imbalances can trigger seizures.
- Fever (febrile seizures): In young children, high fevers can sometimes provoke seizures.
Symptoms: Seizures may manifest as:
- Generalized seizures: These involve both sides of the brain and can result in muscle jerking, loss of consciousness, and incontinence (e.g., tonic-clonic seizures).
- Focal seizures: These affect only one part of the brain and may cause symptoms such as twitching in one area of the body, altered sensations, or speech difficulties.
- Absence seizures: Brief lapses in awareness, often characterized by staring and subtle movements like blinking or lip-smacking.
Nursing Interventions:
- Seizure Precautions: Ensure safety during seizures by placing the child on their side, clearing the area of sharp objects, and monitoring for airway patency.
- Medications: Administer anti-seizure medications (e.g., phenytoin, levetiracetam) as prescribed to control and prevent seizures.
- Monitoring and Documentation: Document the duration, type, and frequency of seizures to help guide treatment decisions.
- Education: Educate the child’s family about seizure triggers, medication adherence, and emergency protocols in case of a seizure.
- Psychosocial Support: Children with seizure disorders may experience anxiety or depression. Providing emotional support and encouraging involvement in school and social activities is important for their well-being.
What are the key clinical features and nursing management strategies for a child with Guillain-Barré Syndrome (GBS)?
Answer:
Pathophysiology: Guillain-Barré Syndrome (GBS) is an autoimmune disorder that causes the body’s immune system to attack the peripheral nerves. The syndrome often follows an infection, such as a viral or bacterial illness. The resulting nerve inflammation leads to muscle weakness and, in severe cases, paralysis. GBS progresses in a manner that may result in respiratory failure and autonomic dysfunction.
Clinical Features: The initial signs and symptoms of GBS may include:
- Progressive weakness, typically starting in the legs and ascending to the arms
- Tingling or numbness in the extremities
- Loss of deep tendon reflexes
- Difficulty breathing in severe cases due to respiratory muscle weakness
- Autonomic dysfunction, such as blood pressure changes, heart rate abnormalities, or digestive issues.
Nursing Management:
- Respiratory Support: Monitor for signs of respiratory distress, and be prepared to assist with ventilation if needed. Some children may require mechanical ventilation.
- Plasma Exchange and Immunoglobulin Therapy: Administer treatments such as plasmapheresis or IV immunoglobulin (IVIG) to reduce inflammation and improve nerve function.
- Physical Therapy: Early involvement of physical therapy to help the child regain muscle strength and mobility as the condition improves.
- Monitoring for Complications: Monitor for cardiac arrhythmias, blood pressure changes, and deep vein thrombosis (DVT).
- Emotional Support: The child may experience anxiety or frustration due to the rapid progression of the condition and temporary paralysis. Offer support and reassure the family about the likelihood of recovery with appropriate treatment.
Analyze the clinical presentation, diagnostic evaluation, and nursing interventions for a child with a brain tumor.
Answer:
Clinical Presentation: Brain tumors in children present with a variety of symptoms depending on the tumor’s size, location, and type. Common symptoms include:
- Headaches, which may worsen over time, especially in the morning
- Vomiting, often without nausea and may be related to increased intracranial pressure (ICP)
- Seizures, depending on the tumor’s location in the brain
- Neurological deficits, such as changes in vision, speech difficulties, or weakness in limbs
- Behavioral changes, including irritability, lethargy, or personality changes
Diagnostic Evaluation: The diagnosis of a brain tumor typically involves several steps:
- Neurological Exam: A thorough assessment to detect any neurological deficits.
- Imaging: A CT scan or MRI is essential for identifying the tumor’s location, size, and characteristics.
- Biopsy: If necessary, a biopsy may be performed to determine the type of tumor.
Nursing Interventions:
- Monitor ICP: Assess for signs of increased ICP, such as changes in consciousness, pupil reaction, or vomiting.
- Post-operative Care: After surgical removal of the tumor, monitor vital signs, and neurological status, and manage pain effectively. Ensure that the child’s head is kept elevated to reduce ICP.
- Pain and Symptom Management: Provide pain relief, antiemetic medications, and anticonvulsants as prescribed.
- Family Education: Educate the family about the tumor type, treatment options, and the long-term prognosis.