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Hydration, nutritionInjury prevention Reye SyndromeRapidly progressive encephalopathy (altered brain function) which begins shortly after a viral infection (influenza or varicella – chicken pox)Affects primarily brain (cerebral edema) and liver (fatty changes) Administration of aspirin associated with developmental of Reye’s Syndrome. Early diagnosis is vital. “Laymans” TermSo, your liveris a major organ in our body. Liverfilters our bloodfrom all of the bad stuff in our blood and it gets out the waste products in our blood. If our body is just skipping over the blood filtering process, and we will have things like ammonia. Having that ammonia in your cerebral spinal fluid and within the brain itself is detrimental.oFirst of all, it’s alkaline. So, this basic product is in your brain, changing the pH of your brain. oAmmonia fights with potassium for binding spots. So, what potassium normally is doing within your brain allowing the cell walls to work and to fight you properly. The potassium is now fighting for that. So, you have an increase on your potassium within the blood because it’s now attached to the cells within your brain and you have ammonia attached to the cell walls and ammonia is not doing the proper job that potassium would. So, the firing of the neurons becomes less. Stage 1 having the increased amounts of ammonia in the brain causes the signs and symptoms of lethargy, as well as vomiting, Stage 2, you began to see seizures. Stage 3, you can see fixed pupils or you will see fixed pupils. But this is really a concerning stage. This is the stage we can start to really fall off a cliff and may go very very fast. Once you hit stage 3, you go to coma and then stage 5 is death. So, having an enlarge vein is very problematic for the pediatric patient.Liver also converts glycogen into glucose and glucose into glycogen.This is how our body uses sugar. And sugar, of course is something that we need to have any sort of ATP anywhere in our body. It gives us energy everywhere. So, we need to have these sugars within our cells. So, if the liver is not co-producing the back and forth between glycogen and glucose, we are going to see hyper and hypoglycemic stateswithin the pediatric child. For the pediatric population, it’s usually hypoglycemic. Liver creates clottingfactors, so you’ll want to be checking the PT, PTTlabs. You would also check your liver labs which will be ALTand AST– this will be increased. oWe want to reduce the effects of having an encephalopathywithin that child. So, you’ll want to be giving them a hypertonic solutionto try and bring down any sort of extra swelling that we can or any increased intracranial pressure.Assessment (S/S)History of viral illnessProgressive neurologic declineFeverRash (hands and feet)
Cerebral NotesVomiting (effortless)Elevated ammoniaRespiratory arrestProfound, impaired consciousnessComaTherapeutic ManagementSupportive care based on the stageEstablish and maintain patent airwayAssess and treat hypoglycemiaProvide rest and decrease stimulationMonitor I&Os