p.33
Diagnosis and Treatment Approaches
What is the purpose of a ventriculo-atrial (VA) shunt?
To enable cerebrospinal fluid (CSF) to flow from the cerebral ventricular system to the atrium of the heart.
p.3
Types of Neural Tube Defects
What is spina bifida?
A defect in one or more vertebrae through which spinal cord contents can protrude.
What is the prevalence of neural tube defects in countries without folic acid supplementation?
0.5 to 2 per 1000 live births.
What is a neural tube defect?
A congenital disorder where the neural tube fails to close properly, leading to conditions such as spina bifida.
p.56
Diagnosis and Treatment Approaches
What types of exercise therapy are mentioned for treatment?
Swimming and hippotherapy (horseback riding).
p.34
Diagnosis and Treatment Approaches
What is the purpose of external ventricular drainage (EVD)?
To manage acute or persistent infection cases by draining cerebrospinal fluid externally.
p.3
Types of Neural Tube Defects
What is anencephaly?
A condition where the brain does not develop above the brainstem.
What is Spina Bifida Cystica?
A defect in closure of the posterior vertebral arch with protrusion through the bony spine.
p.7
Types of Neural Tube Defects
What is a meningocele?
A spinal fluid-filled meningeal sac filled with CSF that protrudes through a vertebral defect.
p.41
Nursing Management Pre and Post-Operative Care
What is one of the key outcomes for post-shunting care in nursing management?
The child develops neck muscle control to interact with the environment.
p.34
Diagnosis and Treatment Approaches
What is an endoscopic third ventriculostomy?
A surgical procedure used to treat hydrocephalus by creating a pathway to allow cerebrospinal fluid to flow within the brain.
p.3
Types of Neural Tube Defects
What does myelodysplasia refer to?
Any malformation of the spinal cord and spinal canal.
p.6
Types of Neural Tube Defects
What are the two anomalies resulting from Spina Bifida Cystica?
Meningocele and Meningomyelocele.
p.18
Nursing Management Pre and Post-Operative Care
What type of exercise is recommended for a baby with neuromuscular impairment pre-operatively?
Gentle range of motion (ROM) exercise to extremities.
p.12
Diagnosis and Treatment Approaches
What is a common postnatal diagnostic method involving light to examine a lesion?
Neonatal exam with transillumination of the lesion.
p.41
Nursing Management Pre and Post-Operative Care
What is an important outcome to prevent complications in post-shunting care?
The child will not suffer from CSF drainage & pressure on valves.
Are contractures common in individuals with dyskinetic/athetoid CP?
No, contractures are rare.
What causes the failure of neural tube closure during early development?
The failure occurs during the first 3 to 5 weeks of embryonic development.
What is myelomeningocele?
A spinal fluid-filled meningeal sac that contains a portion of the meninges, spinal cord, or nerve roots.
p.56
Diagnosis and Treatment Approaches
What are some alternative treatments for neurological disorders?
Botox injections and hyperbaric oxygen therapy (HBOT).
p.18
Nursing Management Pre and Post-Operative Care
What is the goal of pre-operative nursing management for a baby with neuromuscular impairment?
The baby will be free of injury.
p.31
Diagnosis and Treatment Approaches
What is the primary goal of treatment for conditions involving excess cerebrospinal fluid (CSF)?
To relieve pressure, prevent or manage complications, and remove underlying causes.
How do the involuntary movements in dyskinetic/athetoid CP change with sleep and stress?
The movements often disappear during sleep and increase with stress.
p.7
Types of Neural Tube Defects
What is the usual neurological deficit in meningocele?
There is usually little or no neurologic deficit.
p.41
Nursing Management Pre and Post-Operative Care
What skin-related outcome is important in post-shunting care?
The child will not show signs of skin breakdown.
p.28
Clinical Manifestations and Complications
What can abnormal infantile reflexes indicate?
They can be a sign of neurological disorders in infants.
Why might fluid leakage occur in myelomeningocele?
Because the lesion is poorly covered with imperfect tissue.
p.20
Nursing Management Pre and Post-Operative Care
How should an infant be fed pre-operatively to promote growth and development?
Feed the infant with the head turned to one side until surgery has been performed.
p.14
Multidisciplinary Treatment and Support
What are the main focuses of treatment in a multidisciplinary approach for neurological defects?
The defect itself and associated problems such as hydrocephalus, paralysis, orthopedic deformities, and genitourinary abnormalities.
p.7
Types of Neural Tube Defects
What does the sac covering the defect in meningocele look like?
The sac may be translucent or membranous.
p.28
Clinical Manifestations and Complications
What are common clinical manifestations in infants with neurological disorders?
Poor feeding, increased irritability, and lethargy with varying degrees of conscious level.
p.28
Clinical Manifestations and Complications
What might cranial nerve damage in an infant suggest?
It may suggest brain stem compression.
What are neural tube defects?
Abnormalities that are derived from the embryonic neural tube.
What does the meningeal sac in myelomeningocele contain?
A portion of the meninges, spinal cord, or nerve roots.
p.14
Multidisciplinary Treatment and Support
Which specialists are typically involved in the multidisciplinary treatment approach?
Neurologist, neurosurgeon, pediatrician, urologist, orthopedics doctors, NICU nurse, physical therapist, and social worker.
p.20
Nursing Management Pre and Post-Operative Care
What is important to calculate and ensure for an infant pre-operatively?
Sufficient daily nutrition intake.
What are the main symptoms of dyskinetic/athetoid CP?
Constant involuntary writhing motions that affect the entire body but are more severe distally.
p.7
Types of Neural Tube Defects
What is the position of the spinal cord and spinal root in meningocele?
The spinal cord and spinal root are in normal position.
p.37
Nursing Management Pre and Post-Operative Care
What fluid-related outcome is identified in pre-shunting care for a child?
The child will not have increased fluid volume prior to operation.
p.41
Nursing Management Pre and Post-Operative Care
How should shunt infections and malfunctions be managed according to post-shunting care guidelines?
Shunt infections & malfunctions are identified by the parents & medical attention is sought quickly.
p.28
Clinical Manifestations and Complications
What severe complication can occur in extreme cases of infant neurological disorders?
Cardiopulmonary depression.
p.14
Multidisciplinary Treatment and Support
What type of approach is used for the treatment of certain neurological defects?
A multidisciplinary approach.
p.37
Nursing Management Pre and Post-Operative Care
What is another outcome identified in pre-shunting care regarding the child's skin?
The child will not show signs of skin breakdown.
p.20
Nursing Management Pre and Post-Operative Care
Why is it important to communicate with the child pre-operatively?
To promote growth and development.
p.41
Nursing Management Pre and Post-Operative Care
What is a key developmental outcome for a child receiving post-shunting care?
The child’s potential for growth & development is maximized by care and a stimulating environment.
What are some potential factors associated with the etiology of neural tube defects?
Folic acid deficiency, medications, radiation, excessive use of alcohol, and genetic factors.
p.39
Nursing Management Pre and Post-Operative Care
Why is it important to calculate and ensure sufficient daily nutrition intake in pre-shunting care?
To ensure the child receives adequate nutrition for growth and recovery.
What is the neural tube?
The tissue that ultimately develops the CNS, including the brain and spinal cord.
p.33
Diagnosis and Treatment Approaches
What is the purpose of a ventriculo-pleural shunt?
To enable cerebrospinal fluid (CSF) to flow from the cerebral ventricular system to the pleural space.
p.3
Types of Neural Tube Defects
What is encephalocele?
A protrusion of meningeal tissue or meningeal-covered brain observed through a defect in the skull.
What is cerebral palsy?
A group of disorders affecting movement and muscle tone or posture, caused by damage that occurs to the immature brain as it develops, most often before birth.
p.37
Nursing Management Pre and Post-Operative Care
What is one of the outcomes identified in pre-shunting care for a child?
The child’s neck muscle will not show signs of strain.
p.18
Nursing Management Pre and Post-Operative Care
How should a baby with neuromuscular impairment be positioned pre-operatively?
With hips abducted and feet in a neutral position.
p.12
Diagnosis and Treatment Approaches
Which imaging techniques are used postnatally to diagnose neural tube defects?
CT scans, MRI scans, and myelography.
p.7
Diagnosis and Treatment Approaches
What is the typical treatment for meningocele?
Surgical intervention after birth.
p.12
Diagnosis and Treatment Approaches
What are the prenatal diagnostic methods for detecting neural tube defects?
Ultrasound (USG), maternal serum alpha fetoprotein, and amniocentesis.
What specific dyskinetic movements are associated with the mouth in dyskinetic/athetoid CP?
Dyskinetic movement of the mouth causing drooling and dysarthria.
What is Spina Bifida?
A common developmental disorder of the CNS characterized by incomplete closure of the vertebrae and neural tube.
p.4
Types of Neural Tube Defects
What are the two types of Spina Bifida?
Spina bifida occulta and Spina bifida cystica.
p.57
Nursing Management Pre and Post-Operative Care
How can nurses promote adequate fluid and nutrition intake in children with congenital neurological disorders?
By using special feeding techniques.
What is hydrocephalus?
A condition characterized by an abnormal accumulation of cerebrospinal fluid within the brain's ventricles, leading to increased intracranial pressure.
What is a visible characteristic of Spina Bifida Cystica?
An external saclike protrusion.
p.20
Nursing Management Pre and Post-Operative Care
What type of stimulation should be provided to an infant pre-operatively?
Tactile stimulation such as touching and patting.
p.18
Nursing Management Pre and Post-Operative Care
What should be done to the knees and other bony prominences of a baby with neuromuscular impairment pre-operatively?
Massage the knees and other bony prominences regularly, and pad the bony prominences.
What is hydrocephalus?
An imbalance between production and absorption of CSF in the ventricular system or blockage in the flow of CSF.
p.21
Nursing Management Pre and Post-Operative Care
Why should pressure be avoided on the operated site post-operatively?
To prevent complications and promote healing.
p.37
Nursing Management Pre and Post-Operative Care
What nutritional outcome is identified in pre-shunting care for a child?
The child will have proper intake of nutrition and exhibit normal weight gain.
p.39
Nursing Management Pre and Post-Operative Care
What routine preparations are part of pre-shunting care?
Routine pre-operative preparations.
p.57
Nursing Management Pre and Post-Operative Care
How can nurses ensure a child's body is in the best possible alignment?
By using ankle-foot orthosis, braces, and mobilization devices.
p.57
Nursing Management Pre and Post-Operative Care
What should nurses do to prepare children and their families for procedures, treatments, appliances, and surgeries?
Provide thorough preparation and education.
p.16
Nursing Management Pre and Post-Operative Care
What is the primary aim of pre-operative nursing management for a congenital abnormality over the back?
To protect the sac, prevent further skin breakdown, and infection.
p.21
Nursing Management Pre and Post-Operative Care
What is an important aspect of pain management post-operatively?
Performing wound care as per post-op orders.
p.31
Diagnosis and Treatment Approaches
What are the surgical interventions used to treat excess CSF?
Removal of any space-occupying lesion or creating a new CSF pathway to divert excess CSF.
p.28
Clinical Manifestations and Complications
What type of cry might indicate a neurological issue in an infant?
A high-pitched or cat-like cry.
What factors determine the degree of neurologic dysfunction in neural tube defects?
The location where the sac protrudes through the vertebrae, the anatomic level of the defect, and the amount of nerve tissue involved.
p.57
Nursing Management Pre and Post-Operative Care
What is a key aspect of nursing management to prevent physical injury in children?
Ensuring the child's body is in proper alignment and using appropriate devices.
p.16
Nursing Management Pre and Post-Operative Care
Why should diapering be avoided in pre-operative care for a congenital abnormality over the back?
To avoid direct pressure and trauma to the lesion.
p.16
Nursing Management Pre and Post-Operative Care
What type of dressing pad is recommended to protect the lesion?
A silicone-based or non-stick dressing pad.
p.21
Nursing Management Pre and Post-Operative Care
What is the goal of subsequent care post-operatively?
To optimize physical functions and prevent complications.
p.39
Nursing Management Pre and Post-Operative Care
What is the primary goal of pre-shunting care in nursing management?
To provide safety care and risk precaution.
p.16
Nursing Management Pre and Post-Operative Care
In what environment should the baby be cared for pre-operatively?
In either an incubator or a warm environment.
p.21
Nursing Management Pre and Post-Operative Care
What are the key components of post-operative assessment in nursing management?
Monitor vital signs, hydration status, and pain level.
p.21
Nursing Management Pre and Post-Operative Care
What complications should be monitored for post-operatively?
Hydrocephalus, increased intracranial pressure (ICP), meningitis, wound infection, or leakage of cerebrospinal fluid (CSF).
p.39
Nursing Management Pre and Post-Operative Care
How can nurses prevent aspiration and promote nutritional intake in pre-shunting care?
By giving small frequent feedings and frequent burping.
Where can Spina Bifida occur along the vertebral column?
It can occur anywhere along the vertebral column.
p.16
Nursing Management Pre and Post-Operative Care
What position should the baby be nursed in to avoid direct pressure and trauma?
In a prone position with the use of rolls, pads, or pillows.
p.39
Nursing Management Pre and Post-Operative Care
How can nurses promote bonding and parents' acceptance of the child in pre-shunting care?
By encouraging parental-child bonding and supporting parents.
p.57
Nursing Management Pre and Post-Operative Care
What is an important aspect of nursing management related to medication?
Administering prescribed medications.
p.57
Nursing Management Pre and Post-Operative Care
What is one of the primary goals of nursing management for children with congenital neurological disorders?
To prevent physical deformity and promote mobility.
p.21
Nursing Management Pre and Post-Operative Care
What position should a child be placed in post-operatively?
Prone or side-lying position.
