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.
Why might fluid leakage occur in myelomeningocele?
Because the lesion is poorly covered with imperfect tissue.
p.7
Types of Neural Tube Defects
What is the usual neurologic deficit in meningocele?
There is usually little or no neurologic deficit.
What is the primary aim of treatment for infants or children with CP?
To enable the infant or child to achieve the best movement, locomotion, and communication skills.
p.13
Diagnosis and Treatment Approaches
What is the primary goal of treatment for neural tube defects?
Supportive care with no cure.
p.30
Diagnosis and Treatment Approaches
How is hydrocephalus diagnosed before birth?
Through prenatal ultrasound (USG) showing disproportionately large lateral and 3rd ventricles.
p.48
Clinical Manifestations and Complications
What are some common clinical manifestations of neurological disorders in infants and children?
Alterations in muscle tone and coordination, continued primitive reflex responses, delay in gross and fine motor skills, inability to perform age-appropriate ADLs, poor vision, strabismus or nystagmus, hearing loss, cognitive impairments, speech and language delays, seizures, and growth problems.
p.35
Clinical Manifestations and Complications
Which patients are especially at risk for infection during a shunting procedure?
Those with intraventricular hemorrhage or CNS infection at the time of surgery.
p.38
Nursing Management Pre and Post-Operative Care
How can head and neck injuries be prevented in pre-shunting care?
Do not stretch or strain the neck muscle, position the child carefully, and support the head and neck in midline or neutral position with small towel rolls and pillows.
p.22
Nursing Management Pre and Post-Operative Care
What is a key preventive measure in nursing management for children with disabilities?
Preventing urinary complications.
p.41
Nursing Management Pre and Post-Operative Care
How should shunt infections and malfunctions be managed post-shunting?
Shunt infections and malfunctions are identified by the parents and medical attention is sought quickly.
What are some potential factors associated with the etiology of neural tube defects?
Potential factors include folic acid deficiency, medications, radiation, excessive use of alcohol, and genetic factors.
p.31
Diagnosis and Treatment Approaches
What are some surgical interventions used to treat excess CSF?
Removal of any space-occupying lesion or creating a new CSF pathway to divert excess CSF.
p.14
Multidisciplinary Treatment and Support
Which specialists are typically involved in the multidisciplinary treatment of congenital neurological disorders?
Neurologist, neurosurgeon, pediatrician, urologist, orthopedics doctors, NICU nurse, physical therapist, and social worker.
p.45
Clinical Manifestations and Complications
What is a common symptom of shunt malfunction or infection related to head discomfort?
Headache, progressive or worsening.
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.
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.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.30
Diagnosis and Treatment Approaches
What can USG, CT, and MRIs detect in patients with hydrocephalus?
Ventricular dilation/enlargement, structural defect, obstruction, or lesion.
p.48
Clinical Manifestations and Complications
What motor skill delays are common in children with neurological disorders?
Delay in gross and fine motor skills.
p.48
Clinical Manifestations and Complications
What daily activities might children with neurological disorders struggle to perform?
Age-appropriate activities of daily living (ADLs).
p.52
Diagnosis and Treatment Approaches
At what age may a definite diagnosis be possible for certain neurological conditions in children?
Between 18 months and 2 years of age.
p.41
Nursing Management Pre and Post-Operative Care
What skin-related outcome is important for a child post-shunting?
The child will not show signs of skin breakdown.
p.7
Types of Neural Tube Defects
What is meningocele?
A spinal fluid-filled meningeal sac filled with CSF that protrudes through a vertebral defect.
p.23
Nursing Management Pre and Post-Operative Care
What should nurses teach parents about before discharge?
Administration of medication.
What is the neural tube?
The tissue that ultimately develops the CNS, including the brain and spinal cord.
p.45
Clinical Manifestations and Complications
What symptom of shunt malfunction or infection involves unusual sleep patterns?
Drowsiness or inappropriate sleepiness during the day.
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.58
Multidisciplinary Treatment and Support
Why is it important for nurses to collaborate with multidisciplinary therapeutic measures?
To provide comprehensive care that addresses all aspects of the child's health and development.
p.11
Clinical Manifestations and Complications
What are some common neurological complications associated with neural tube defects?
Chiari II malformation, hydrocephalus, and meningitis.
p.11
Clinical Manifestations and Complications
What are some physical complications that can arise from neural tube defects?
Weakness or paralysis of hips, legs, and feet.
p.11
Clinical Manifestations and Complications
What urinary complications can occur due to neural tube defects?
Urinary retention or urinary tract infections (UTI).
p.58
Nursing Management Pre and Post-Operative Care
How can nurses assist in seeking appropriate educational, functional, and vocational training for the child?
By helping families find and access suitable programs and resources that support the child's development and future independence.
p.11
Clinical Manifestations and Complications
What are some other complications that can occur with neural tube defects?
Skin problems or latex allergy.
p.35
Clinical Manifestations and Complications
What are some abdominal complications that can arise from a shunting procedure?
Peritonitis, abdominal abscess, perforation of organs, fistulas, hernias, and ileus.
p.40
Nursing Management Pre and Post-Operative Care
What signs should be monitored for indicating shunt malfunction, increased ICP, or infection?
Any signs of shunt malfunction, increased intracranial pressure (ICP), or infection.
What is Spina Bifida?
A common developmental disorder of the CNS characterized by incomplete closure of the vertebrae and neural tube.
p.6
Types of Neural Tube Defects
What are the two anomalies that can result from Spina Bifida Cystica?
Meningocele and Meningomyelocele.
What happens when the amount of CSF absorbed is less than the amount produced?
The ventricles enlarge, leading to dilation of ventricles and compression of brain parenchyma against the skull, resulting in increased intracranial pressure (ICP).
p.3
Types of Neural Tube Defects
What is anencephaly?
A condition where the brain does not develop above the brainstem.
p.11
Clinical Manifestations and Complications
What factors determine the clinical manifestations and complications of neural tube defects?
Size and location of the malformation, whether it is covered or uncovered, and the involved spinal nerve.
p.13
Diagnosis and Treatment Approaches
What types of interventions are used in late childhood for neural tube defects?
Correction of musculoskeletal deformities through bracing, splinting, walking aids, physiotherapy, and surgery.
p.13
Diagnosis and Treatment Approaches
What are some management strategies for urologic and bowel control problems in neural tube defect patients?
Various medical and surgical interventions tailored to individual needs.
p.58
Nursing Management Pre and Post-Operative Care
What role do nurses play in facilitating communication with the child and promoting a positive self-image?
Nurses assist in developing communication strategies and encourage activities that build the child's self-esteem.
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.29
Clinical Manifestations and Complications
What are some eye-related symptoms of neurological disorders in children?
Papilledema and strabismus.
p.22
Nursing Management Pre and Post-Operative Care
What should be assessed regarding the family's ability to care for a child with disabilities?
The family's resources and ability.
p.52
Diagnosis and Treatment Approaches
What other types of disorders should be excluded when diagnosing neurological conditions in children?
Metabolic, degenerative, or neoplastic diseases.
p.28
Clinical Manifestations and Complications
What might cranial nerve damage in infants suggest?
It may suggest brain stem compression.
p.47
Common Congenital Neurological Disorders
What are some maternal prenatal factors that can contribute to neurological disorders?
Vaginal bleeding, preeclampsia, intrauterine drug exposure.
p.47
Common Congenital Neurological Disorders
What are some fetal prenatal factors that can contribute to neurological disorders?
Prematurity, genetic or chromosomal abnormalities, brain malformation, multiple fetuses, intrauterine exposure to maternal infections.
p.31
Diagnosis and Treatment Approaches
What are the primary goals of treatment for conditions involving excess cerebrospinal fluid (CSF)?
To relieve pressure, prevent or manage complications, and remove underlying causes.
What is the consequence of ventricles enlarging in the brain?
Dilation of ventricles and compression of brain parenchyma against the skull, leading to increased intracranial pressure (ICP).
p.23
Nursing Management Pre and Post-Operative Care
What should be provided to parents upon discharge?
Referral and appointment dates.
What are neural tube defects?
Abnormalities that are derived from the embryonic neural tube.
p.20
Nursing Management Pre and Post-Operative Care
What should be calculated and ensured for an infant pre-operatively?
Sufficient daily nutrition intake.
What are the main symptoms of Spastic Cerebral Palsy?
Muscular spasms, hypertonicity, uncoordinated, awkward and stiff movement, impairment of fine and gross motor skills, abnormal posturing/gait, and contractures.
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.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.
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.
p.21
Nursing Management Pre and Post-Operative Care
What position should a child be placed in post-operatively?
In the prone or side-lying position.
p.38
Nursing Management Pre and Post-Operative Care
What steps can be taken to prevent impaired skin integrity in pre-shunting care?
Provide skin care and protection to the head, place sheepskin or other pressure release devices under the head, and reposition the child regularly.
p.52
Diagnosis and Treatment Approaches
What aspects of a child's development are reviewed to diagnose neurological conditions?
The child's motor milestones.
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.28
Clinical Manifestations and Complications
What can abnormal infantile reflexes indicate?
They can be a sign of neurological disorders in infants.
p.27
Clinical Manifestations and Complications
What might dilated scalp veins in an infant suggest?
Increased intracranial pressure.
p.27
Clinical Manifestations and Complications
What is Macewen’s sign and what does it indicate?
Macewen’s sign is a resonant sound heard on percussion of the skull, indicating increased intracranial pressure.
p.32
Diagnosis and Treatment Approaches
What is the function of the ventricular catheter in a VP shunt?
To transport CSF from the ventricle.
p.43
Nursing Management Pre and Post-Operative Care
What should be administered if a child is in pain post-shunting?
Analgesics, if necessary.
p.15
Nursing Management Pre and Post-Operative Care
What is the initial care focus in pre-operative nursing management?
Prevent local infection and injury.
p.42
Nursing Management Pre and Post-Operative Care
What is the primary goal of post-shunting care in nursing management?
To provide safety care and risk precaution.
What is a neural tube defect?
A congenital disorder where the neural tube fails to close properly during early fetal development.
What is hydrocephalus?
A condition characterized by an abnormal accumulation of cerebrospinal fluid within the brain's ventricles.
p.34
Diagnosis and Treatment Approaches
What is the purpose of external ventricular drainage (EVD)?
To manage acute or persistent infections by draining cerebrospinal fluid externally.
What does the meningeal sac in myelomeningocele contain?
A portion of the meninges, spinal cord, or nerve roots.
p.7
Types of Neural Tube Defects
What does the sac covering the defect in meningocele look like?
It may be translucent or membranous.
p.23
Nursing Management Pre and Post-Operative Care
What should be assured and documented before discharging a newborn?
Newborn vaccines should be complete and documented.
What is hydrocephalus?
An imbalance between production and absorption of CSF in the ventricular system or blockage in the flow of CSF.
What does the prognosis of this condition depend on?
The cause of the condition.
Is there a cure for Cerebral Palsy (CP)?
No, there is no cure for CP.
p.56
Diagnosis and Treatment Approaches
What are some alternative treatments for neurological disorders?
Botox injections and hyperbaric oxygen therapy (HBOT).
p.7
Diagnosis and Treatment Approaches
What is the typical treatment for meningocele?
Surgical intervention after birth.
p.56
Diagnosis and Treatment Approaches
What types of exercise therapy are used in the treatment of neurological disorders?
Swimming and hippotherapy (horseback riding).
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.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.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.
What is the prevalence of neural tube defects in countries without folic acid supplementation?
0.5 to 2 per 1000 live births.
What is Cerebral Palsy?
A chronic nonprogressive motor dysfunction caused by damage to the motor areas of the brain.
p.12
Diagnosis and Treatment Approaches
What are the prenatal diagnostic methods for detecting neural tube defects?
USG, Maternal serum alpha fetoprotein, and Amniocentesis.
p.45
Clinical Manifestations and Complications
What behavioral changes might suggest a shunt malfunction or infection?
Personality changes or changes in school performance.
p.20
Nursing Management Pre and Post-Operative Care
What types of tactile stimulation should be provided to a child pre-operatively?
Touching, patting, and communicating with the child.
p.13
Diagnosis and Treatment Approaches
Why is it important to protect the exposed nerves in neural tube defects?
To prevent further damage and complications.
What causes Cerebral Palsy?
Injury or insult to the brain either before, during birth, or in early infancy.
p.30
Diagnosis and Treatment Approaches
What are the methods used to diagnose hydrocephalus after birth?
Health history and physical examination, plain skull X-ray, USG, CT, and MRIs.
p.13
Diagnosis and Treatment Approaches
What is an example of an early surgical intervention for neural tube defects?
Uteromyelomeningocele repair or myelomeningocele repair within 24 to 48 hours of the baby’s birth.
p.30
Diagnosis and Treatment Approaches
What does a plain skull X-ray reveal in infants with hydrocephalus?
Macrocranium with wide cranial sutures.
p.45
Clinical Manifestations and Complications
What local signs along the shunt tract might indicate infection?
Redness or swelling along the shunt tract.
What is myelomeningocele?
A spinal fluid-filled meningeal sac that contains a portion of the meninges, spinal cord, or nerve roots.
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.14
Multidisciplinary Treatment and Support
What type of approach is recommended for treating congenital neurological disorders?
A multidisciplinary approach.
p.7
Types of Neural Tube Defects
What is the position of the spinal cord and spinal root in meningocele?
They are in normal position.
p.14
Diagnosis and Treatment Approaches
What are the main focuses of treatment for congenital neurological disorders?
The defect and the problems associated with the defect, such as hydrocephalus, paralysis, orthopedic deformities, and genitourinary abnormalities.
p.23
Nursing Management Pre and Post-Operative Care
What services should be coordinated for supportive care and follow-ups?
Services like CNS and the Spina Bifida Support Group of Hong Kong.
p.3
Types of Neural Tube Defects
What does myelodysplasia refer to?
Any malformation of the spinal cord and spinal canal.
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.
p.12
Diagnosis and Treatment Approaches
What is used in a postnatal diagnosis to examine a lesion in a neonate?
Neonatal exam with transillumination of the lesion.
What are the three types of Spastic Cerebral Palsy?
Hemiplegia, diplegia, and quadriplegia.
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.
What type of movement is associated with Spastic Cerebral Palsy?
Uncoordinated, awkward, and stiff movement.
p.57
Nursing Management Pre and Post-Operative Care
What is an important aspect of nursing management to prevent physical injury in children?
Ensuring the child’s body is in the best possible alignment and using appropriate devices.
p.22
Nursing Management Pre and Post-Operative Care
What should be evaluated in nursing management for children with disabilities?
The extent of disabilities and providing supportive care.
p.57
Nursing Management Pre and Post-Operative Care
What should nurses promote to ensure adequate fluid and nutrition intake in children?
Special feeding techniques.
p.57
Nursing Management Pre and Post-Operative Care
How should nurses prepare children and their families for medical procedures?
By preparing them for procedures, treatment, appliances, and surgeries as necessary.
p.57
Nursing Management Pre and Post-Operative Care
What is a key responsibility of nurses in managing children with congenital neurological disorders?
Administering prescribed medications.
p.39
Nursing Management Pre and Post-Operative Care
How can nurses promote bonding and parents' acceptance of the child during pre-shunting care?
By encouraging parental-child bonding and supporting parents.
p.38
Nursing Management Pre and Post-Operative Care
What measures should be taken to prevent headaches in pre-shunting care?
Reposition the child slowly and monitor the signs and symptoms of increased intracranial pressure (ICP).
p.39
Nursing Management Pre and Post-Operative Care
What routine preparations are included in pre-shunting care?
Routine pre-operative preparations.
p.29
Clinical Manifestations and Complications
What is a common physical manifestation of neurological disorders in children?
Abnormal enlargement of the head.
p.22
Nursing Management Pre and Post-Operative Care
How can nursing management promote family coping?
By providing support and education to the family.
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.41
Nursing Management Pre and Post-Operative Care
What is a key outcome for maximizing a child's potential for growth and development post-shunting?
The child’s potential for growth and development is maximized by care and a stimulating environment.
p.52
Diagnosis and Treatment Approaches
What components are included in a neurological exam for diagnosing neurological conditions in children?
Reflexes, gait analysis, posture, attitude, muscle size, function, and tone.
p.12
Diagnosis and Treatment Approaches
Which imaging techniques are used in the postnatal diagnosis of neural tube defects?
CT, MRI scans, and myelography.
What motor skills are impaired in Spastic Cerebral Palsy?
Fine and gross motor skills.
p.38
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.
What causes the failure of neural tube closure during early development?
A failure of neural tube closure occurs during the first 3 to 5 weeks of embryonic development.
p.22
Nursing Management Pre and Post-Operative Care
What educational topics should be covered with families in nursing management for children with disabilities?
Knowledge and skills in positioning, feeding, and skin care.
What is Spina Bifida Cystica?
A defect in closure of the posterior vertebral arch with protrusion through the bony spine.
Where can Spina Bifida occur along the vertebral column?
It can occur anywhere along the vertebral column.
p.4
Types of Neural Tube Defects
What are the two types of Spina Bifida?
Spina bifida occulta and Spina bifida cystica.
p.19
Nursing Management Pre and Post-Operative Care
What is the goal of pre-operative nursing management for promoting bonding and parents' acceptance of the child?
To encourage parental-child bonding and increase family coping skills and confidence in caring for the child.
What specific dyskinetic movement affects the mouth in dyskinetic/athetoid CP?
Dyskinetic movement of the mouth causing drooling and dysarthria.
p.32
Diagnosis and Treatment Approaches
Why is the abdomen chosen as the drainage site for a VP shunt?
Because it has a large space to accommodate the catheter.
p.43
Nursing Management Pre and Post-Operative Care
When should antibiotics be administered post-shunting?
If needed, to prevent infection.
p.17
Nursing Management Pre and Post-Operative Care
What is the goal of pre-operative nursing management for a baby with a spinal defect?
The baby will be free of injury.
p.15
Nursing Management Pre and Post-Operative Care
What is the risk of infection related to in pre-operative nursing management?
Vulnerability of the defect over the spine.
p.58
Nursing Management Pre and Post-Operative Care
What should nurses do to address sensory deprivation related to vision and hearing losses?
Refer the child for correction of sensory deprivation.
p.58
Nursing Management Pre and Post-Operative Care
How can nurses promote optimal family functioning?
By providing support and resources to help the family cope and function effectively.
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.48
Clinical Manifestations and Complications
What are some possible deficits other than motor skill delays in children with neurological disorders?
Poor vision, strabismus or nystagmus, hearing loss, cognitive impairments, speech and language delays, seizures, and growth problems.
What percentage of children with neural tube defects also have hydrocephalus?
80-90% of children with neural tube defects also have hydrocephalus.
p.40
Nursing Management Pre and Post-Operative Care
What is a possible nursing diagnosis related to imbalanced fluid volume post-shunting?
Risk of imbalanced fluid volume related to cerebrospinal fluid draining too quickly.
In which area does Spina Bifida mostly occur?
It mostly occurs in the lumbosacral area.
How do the involuntary movements in dyskinetic/athetoid CP change with sleep and stress?
They often disappear during sleep and increase with stress.
p.27
Clinical Manifestations and Complications
What does the presence of sluggish and unequal pupils in an infant suggest?
It may indicate increased intracranial pressure.
p.5
Clinical Manifestations and Complications
What are the manifestations of Spina Bifida Occulta?
A dimple in the skin, nevi, hair tufts (over a dermal sinus), or soft and subcutaneous lipomas.
p.48
Clinical Manifestations and Complications
What are some alterations in muscle tone and coordination seen in infants and children with neurological disorders?
Abnormal posturing and movements.
p.22
Nursing Management Pre and Post-Operative Care
What aspects of development should be monitored as a child with disabilities grows?
Psychosocial development and level of cognitive impairment.
p.35
Clinical Manifestations and Complications
What are some mechanical complications of a shunting procedure?
Blockage at either the proximal or distal end of the catheter, kinking of the tubing, plugging, migrating, or separating of tubing, and valve breakdown.
p.41
Nursing Management Pre and Post-Operative Care
What is a key outcome for a child post-shunting in terms of muscle control?
The child develops neck muscle control to interact with the environment.
p.41
Nursing Management Pre and Post-Operative Care
What is an important outcome to prevent complications related to CSF drainage and valve pressure post-shunting?
The child will not suffer from CSF drainage and pressure on valves.
What factors determine the degree of neurologic dysfunction in neural tube defects?
The degree of neurologic dysfunction depends on where the sac protrudes through the vertebrae, the anatomic level of the defect, and the amount of nerve tissue involved.
p.40
Nursing Management Pre and Post-Operative Care
What is a possible nursing diagnosis related to the risk of infection post-shunting?
Risk of infection related to the introduction of infectious organisms during surgery.
p.52
Diagnosis and Treatment Approaches
What additional assessments are important for diagnosing neurological conditions in children?
Assessment of cognitive function, behavior, and abilities.
p.40
Nursing Management Pre and Post-Operative Care
What is a possible nursing diagnosis related to the risk of injury post-shunting?
Risk of injury related to potential shunt failure.
p.47
Common Congenital Neurological Disorders
What perinatal factors can contribute to neurological disorders?
CNS infection, sepsis, kernicterus.
p.19
Nursing Management Pre and Post-Operative Care
How should nurses handle parents' concerns during the pre-operative period?
Be sympathetic and understanding, and allow parents to express their concerns.
p.16
Nursing Management Pre and Post-Operative Care
In what environment should a baby with a congenital abnormality over the back be cared for?
In either an incubator or a warm environment.
p.43
Nursing Management Pre and Post-Operative Care
How can nurses promote skin integrity and prevent infection post-shunting?
Maintain aseptic technique when performing wound care and administer antibiotics if needed.
p.25
Common Congenital Neurological Disorders
How can prematurity contribute to neurological disorders?
Prematurity is a known risk factor for certain neurological disorders.
p.25
Common Congenital Neurological Disorders
What genetic mutation is associated with some neurological disorders?
Mutation of the X chromosome.
p.44
Nursing Management Pre and Post-Operative Care
What is an important aspect of post-shunting care education for home care?
Education on home care includes wound and shunt care, keeping suture lines clean and dry, and providing proper head support.
p.43
Nursing Management Pre and Post-Operative Care
What is an important aspect of care to promote rest and sleep post-shunting?
Promote a restful environment and ensure the patient is comfortable.
p.32
Diagnosis and Treatment Approaches
What is the function of the distal catheter in a VP shunt?
To carry CSF from the valve to the abdomen.
p.42
Nursing Management Pre and Post-Operative Care
What signs should be assessed to detect any shunt problems for early intervention?
Signs of increased intracranial pressure, over-drainage, infection, malfunction, and leakage.
p.48
Clinical Manifestations and Complications
What primitive reflex responses might continue in children with neurological disorders?
Continued primitive reflex responses.
p.22
Nursing Management Pre and Post-Operative Care
What types of medications might be administered in nursing management for children with disabilities?
Antibiotics and anticonvulsants (if necessary).
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.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.52
Diagnosis and Treatment Approaches
What types of history should be collected for diagnosing neurological conditions in children?
Pre-, peri-, and postnatal history.
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.19
Nursing Management Pre and Post-Operative Care
What is one intervention to promote bonding and parents' acceptance of the child pre-operatively?
Encourage parents and family to participate in caring for the child.
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.
Are contractures common in dyskinetic/athetoid CP?
No, contractures are rare.
p.16
Nursing Management Pre and Post-Operative Care
How often should padding be renewed for a baby with a congenital abnormality over the back?
Every 2-4 hours or when soiled.
p.15
Nursing Management Pre and Post-Operative Care
What are the nursing diagnoses related to impaired skin integrity in pre-operative care?
(Risk of) Impaired skin integrity associated with congenital abnormality over the back.
p.42
Nursing Management Pre and Post-Operative Care
When can routine feeding be resumed after shunt surgery?
After bowel sounds return.
What is a visible characteristic of Spina Bifida Cystica?
An external saclike protrusion.
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.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.47
Common Congenital Neurological Disorders
What early infancy factors can contribute to neurological disorders?
Infection, trauma (e.g., shaken baby syndrome), tumour, toxic ingestion or inhalation.
What kind of movements are poorly performed in Ataxic Cerebral Palsy?
Rapid repetitive movements.
p.25
Common Congenital Neurological Disorders
How can intracranial tumors contribute to neurological disorders?
Intracranial tumors can act as space-occupying lesions, leading to neurological disorders.
p.42
Nursing Management Pre and Post-Operative Care
How should a patient be positioned immediately after shunt surgery?
Lie flat on the un-operated side.
p.43
Nursing Management Pre and Post-Operative Care
What type of care is important for elimination post-shunting?
Elimination care to ensure proper bowel and bladder function.
p.55
Multidisciplinary Treatment and Support
What type of approach is recommended for the treatment of certain neurological disorders?
A team approach with comprehensive treatment.
p.29
Clinical Manifestations and Complications
What behavioral symptoms might indicate a neurological disorder in children?
Irritability, lethargy, apathy, and confusion.
p.16
Nursing Management Pre and Post-Operative Care
What should be done immediately after delivery to protect the sac in a baby with a congenital abnormality over the back?
Cover the sac with a sterile N/S dressing.
What are intention tremors and which type of Cerebral Palsy are they associated with?
Intention tremors are tremors that occur during voluntary movement and are associated with Ataxic Cerebral Palsy.
p.25
Common Congenital Neurological Disorders
What are some acquired causes of neurological disorders?
Space-occupying lesions like intracranial tumors, meningitis, prenatal maternal infection, and brain trauma.
p.43
Nursing Management Pre and Post-Operative Care
What measures can be taken to promote comfort post-shunting?
Assess pain status, administer analgesics if necessary, and promote rest and sleep.
p.15
Nursing Management Pre and Post-Operative Care
What are the key assessments in pre-operative nursing management?
Monitoring vital signs, neurological functions (limb movement, skin sensation, head circumference), and assessing for motor deficits as well as bladder and bowel involvement.
Where does Spina Bifida Occulta commonly occur?
At the 5th lumbar or 1st sacral vertebrae.
p.44
Nursing Management Pre and Post-Operative Care
What abnormal signs and symptoms should be recognized post-shunting?
Signs of shunt infection or malfunction, and peritonitis should be recognized.
p.17
Nursing Management Pre and Post-Operative Care
How should the sac over the spine be protected pre-operatively?
With a sterile dressing moistened in N/S solution, changed every 2 hours.
Is the etiology of neural tube defects known or unknown?
The etiology of neural tube defects is multifactorial and unknown.
p.28
Clinical Manifestations and Complications
What type of cry might indicate a neurological issue in infants?
A high-pitched or cat-like cry.
p.47
Common Congenital Neurological Disorders
What birth-related factors can contribute to neurological disorders?
Complicated labour and delivery, birth injury, asphyxia.
p.25
Common Congenital Neurological Disorders
What are some congenital causes of certain neurological disorders?
Congenital defect such as aqueductal stenosis and associated defects like spina bifida.
p.32
Diagnosis and Treatment Approaches
What are the four parts of a VP shunt?
A ventricular catheter, a pumping chamber or reservoir, a one-way pressure valve, and a distal catheter.
p.43
Nursing Management Pre and Post-Operative Care
How should a nurse assess a child's pain status post-shunting?
By using an appropriate pain assessment tool.
p.25
Common Congenital Neurological Disorders
What role does meningitis play in neurological disorders?
Meningitis, including prenatal maternal infection, can be an acquired cause of neurological disorders.
p.32
Diagnosis and Treatment Approaches
What role does the pumping chamber or reservoir play in a VP shunt?
It helps regulate the flow of CSF.
What is Spina Bifida Occulta?
A form of Spina Bifida where the posterior vertebral arches fail to fuse, usually not visible.
p.42
Nursing Management Pre and Post-Operative Care
Why should the head be gradually elevated after shunt surgery?
To avoid too rapid CSF drainage.
p.42
Nursing Management Pre and Post-Operative Care
What vital signs should be monitored to maintain the function of the shunt?
All vital signs should be monitored.
p.15
Nursing Management Pre and Post-Operative Care
What is the risk of injury related to in pre-operative nursing management?
Neuromuscular impairment.
p.40
Nursing Management Pre and Post-Operative Care
What is a possible nursing diagnosis related to delayed growth and development post-shunting?
Delayed growth and development related to repeated shunt infections and hospitalizations.
p.28
Clinical Manifestations and Complications
What severe complication can occur in extreme cases of neurological disorders in infants?
Cardiopulmonary depression.
p.16
Nursing Management Pre and Post-Operative Care
What is the primary aim of pre-operative nursing management for a baby with a congenital abnormality over the back?
To protect the sac, prevent further skin breakdown, and infection.
p.16
Nursing Management Pre and Post-Operative Care
What type of dressing pad should be used to protect the lesion in a baby with a congenital abnormality over the back?
A silicone-based or non-stick dressing pad.
p.43
Nursing Management Pre and Post-Operative Care
What is a key aspect of nursing management post-shunting care to ensure patient safety?
Provide safety care and risk precaution.
p.32
Diagnosis and Treatment Approaches
What is the purpose of a Ventriculo-Peritoneal (VP) shunt?
To drain cerebrospinal fluid (CSF) from the ventricle to the body's abdomen.
p.27
Clinical Manifestations and Complications
What does a bulging or tense anterior fontanel indicate in an infant?
It can be a sign of increased intracranial pressure.
What is Mixed/Dystonic Cerebral Palsy?
It is a combination of damage that manifests characteristics of both spastic and athetoid Cerebral Palsy.
What are the symptoms of Mixed/Dystonic Cerebral Palsy?
Symptoms of more than one form of Cerebral Palsy, combining characteristics of spastic and athetoid CP.
p.25
Common Congenital Neurological Disorders
How can brain trauma lead to neurological disorders?
Brain trauma is an acquired cause that can result in neurological disorders.
p.32
Diagnosis and Treatment Approaches
What is the purpose of the one-way pressure valve in a VP shunt?
To ensure CSF flows in the correct direction and prevent backflow.
p.15
Nursing Management Pre and Post-Operative Care
What is compromised family coping related to in pre-operative nursing management?
Perceived loss of the perfect newborn.
p.55
Multidisciplinary Treatment and Support
Which specialist in the multidisciplinary team is responsible for surgical interventions and bone-related issues?
Surgeon/Orthopedic doctor.
p.55
Diagnosis and Treatment Approaches
What pharmacologic interventions are used for treating athetoid cerebral palsy?
Muscle relaxants and anxiolytic agents.
p.29
Clinical Manifestations and Complications
What does papilledema indicate in children with neurological disorders?
Blurred disc margins and dilated tortuous vessels.
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.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 them.
p.44
Nursing Management Pre and Post-Operative Care
How should suture lines be maintained post-shunting?
Suture lines should be kept clean and dry, with proper head support.
p.44
Nursing Management Pre and Post-Operative Care
What activities should be avoided for children with hydrocephalus post-shunting?
Contact sports should be avoided.
p.36
Nursing Management Pre and Post-Operative Care
What are some possible nursing diagnoses in pre-shunting care?
Impaired physical mobility, imbalanced nutrition, excessive fluid volume, risk of injury to neck muscles, and risk of impaired skin integrity.
p.36
Nursing Management Pre and Post-Operative Care
What might cause imbalanced nutrition in pre-shunting care?
Potential for vomiting and the need for proper positioning when feeding.
p.19
Nursing Management Pre and Post-Operative Care
Why is it important to explain the child's condition and procedures to the parents pre-operatively?
To ensure parents understand the child's condition and the procedures, which helps in reducing anxiety and increasing their confidence in caring for the child.
What are the main characteristics of dyskinetic/athetoid CP?
Constant involuntary writhing motions that affect the entire body but are more severe distally.
p.16
Nursing Management Pre and Post-Operative Care
What position should a baby with a congenital abnormality over the back be nursed in to avoid direct pressure and trauma?
In a prone position with the use of rolls, pads, or pillows.
p.27
Clinical Manifestations and Complications
What is a common clinical manifestation of increased intracranial pressure in infants?
Increased head circumference.
p.27
Clinical Manifestations and Complications
What does the presence of wide palpable suture lines in an infant indicate?
It can be a sign of increased intracranial pressure.
p.27
Clinical Manifestations and Complications
What is the sun-setting sign in infants?
It is a clinical sign where the eyes appear driven downward, indicating increased intracranial pressure.
p.5
Clinical Manifestations and Complications
What are some symptoms of Spina Bifida Occulta in toddlers?
Abnormal gait with foot weakness or deformity (e.g., foot drop), and bowel and bladder sphincter disturbances.
p.36
Nursing Management Pre and Post-Operative Care
What could impaired physical mobility be related to in pre-shunting care?
Decreased muscle mass to lift the increased weight of the head.
p.44
Nursing Management Pre and Post-Operative Care
Why is it important to encourage a normal lifestyle for children with hydrocephalus?
Encouraging a normal lifestyle helps avoid overprotection, as hydrocephalus is a lifelong problem.
p.17
Nursing Management Pre and Post-Operative Care
What technique should be used routinely to prevent infection in pre-operative nursing management?
Aseptic technique procedures.
p.44
Nursing Management Pre and Post-Operative Care
Why is regular developmental screening important for children with hydrocephalus?
Regular developmental screening helps establish realistic goals and appropriate educational programs.
p.42
Nursing Management Pre and Post-Operative Care
What should be monitored closely to maintain hydration and nutrition post-shunt surgery?
IV fluids, with possible fluid restriction when bowel sounds are present.
p.5
Diagnosis and Treatment Approaches
Is treatment required for Spina Bifida Occulta?
No treatment is required unless there is neurologic damage.
p.36
Nursing Management Pre and Post-Operative Care
What are the key assessments in pre-shunting care for nursing management?
Assess vital signs, fontanels, cranial sutures, level of consciousness (LOC), measure head circumference daily, and monitor signs and symptoms of increased intracranial pressure (ICP).
p.36
Nursing Management Pre and Post-Operative Care
Why is it important to measure head circumference daily in pre-shunting care?
To monitor for changes that may indicate increased intracranial pressure or other complications.
p.36
Nursing Management Pre and Post-Operative Care
What is the cause of excessive fluid volume in pre-shunting care?
Alteration in cerebrospinal fluid (CSF) flow.
What is Spina Bifida?
Spina Bifida is a birth defect where there is incomplete closing of the spine and membranes around the spinal cord.
p.9
Nursing Management Pre and Post-Operative Care
What is the role of nursing management in Spina Bifida care?
Nursing management involves pre and post-operative care, monitoring for complications, and providing support and education to the family.
p.36
Nursing Management Pre and Post-Operative Care
Why is there a risk of injury to neck muscles in pre-shunting care?
Due to the enlarged head and large, heavy cranial vault.
p.9
Types of Neural Tube Defects
What is Meningocele?
Meningocele is a type of Spina Bifida where a sac of fluid comes through an opening in the baby's back, but the spinal cord is not in this sac.
p.9
Types of Neural Tube Defects
What is Myelomeningocele?
Myelomeningocele is the most severe form of Spina Bifida where parts of the spinal cord and nerves come through an open part of the spine.
p.9
Multidisciplinary Treatment and Support
Why is multidisciplinary treatment important for Spina Bifida?
Multidisciplinary treatment is important to address the various physical, developmental, and social needs of individuals with Spina Bifida.
p.9
Types of Neural Tube Defects
What are the types of Spina Bifida?
The main types of Spina Bifida are Spina Bifida Occulta, Meningocele, and Myelomeningocele.
p.9
Types of Neural Tube Defects
What is Spina Bifida Occulta?
Spina Bifida Occulta is the mildest form of Spina Bifida where there is a small gap in the spine but no opening or sac on the back.
p.9
Diagnosis and Treatment Approaches
What are the treatment options for Spina Bifida?
Treatment options include surgery, physical therapy, and assistive devices to manage symptoms and improve quality of life.
p.9
Clinical Manifestations and Complications
What are common complications associated with Spina Bifida?
Common complications include mobility issues, hydrocephalus, and bowel and bladder problems.
p.9
Diagnosis and Treatment Approaches
How is Spina Bifida diagnosed?
Spina Bifida can be diagnosed through prenatal tests such as ultrasound, amniocentesis, and maternal serum alpha-fetoprotein (MSAFP) screening.
