Breath holding spells toddler to preschool age

This preview shows page 10 - 11 out of 30 pages.

Breath-holding spells- toddler to preschool age, behavioral, hold breath, turn blue and pass out, child wakes back up after Infantile spasms- 3 months to 12 years, spasms with abrupt flexion and extension of muscle groups of the neck, trunk, & extremities, involving head nods or jackknife body contractions Status epilepticus- prolonged continuous seizure lasting over 5 minutes, or two or more episodes without return to baseline between, which may result in brain damage. Medical emergency treatment = diazepam, valium, or midazolam Spina Bifida Occulta Spina bifida refers to a defect in one or more vertebrae through which spinal cord contents can protrude, lumbar chiefly affected, and is caused by lack of union between the lamiae (flattened part of vertebrae). Spina bifida occulta is failure of fusion of the posterior vertebral arches without protrusion of spinal cord or meninges, no fluid leaking and it may or may not be visible. S+S: dimple or skin depression, tuft of hair, or port wine stain at lumbar sacral area, gait disturbances, bowel/bladder disturbances Tx: follow up checks Meningocele Saclike protrusion through bony defect containing cerebrospinal fluid, sac covering may be translucent or membranous, and spinal cord and spinal root in normal position. Tx: surgical repair within 24 hours, cannot break membrane death, must be very careful! Myelomeningocele Saclike herniation through bony defect holding meninges, cerebrospinal fluid, nerves, and a portion of spinal cord, fluid leakage may also occur, lesion poorly covered with imperfect tissue, & mobility impairment 99% of time dependent on location! S+S: decreased bladder sphincter control w/ constant dribbling of urine, lack of bowel control, joint deformities
Image of page 10

Subscribe to view the full document.

Tx: saline gauze to site & flat and prone to prevent herniation of brain, surgery within 24 hours, postop is flat, prone, or sidelying, watch for S+S of increased ICP, most develop hydrocephalus which requires a shunt (watch for increased ICP also as shunt can be blocked or infected) Locations: Thoracic & lumbar: paralysis of legs and weak trunk Lumbar 3 (high): can flex hips, extend knees, ankle & toe paralysis Lumbar 4-5 (low); can flex hips, extend knees, toe flexion and hip flexion, may be able to walk Short-term care: focuses on orthopedic and neurologic Long-term care: genitourinary care, catherization q4h while awake to prevent UTI & reflux, oxybutynin (conserves H2O) for bladder control, urinary diversion, depends for accidents, bowel control & training (enemas) Hydrocephalus An imbalance of the production & absorption of cerebrospinal fluid, caused by infection, trauma, or too much CSF absorption as in myelomeningocele S+S: bulging fontanel, increased head circumference, sun setting eyes, irritability, lethargy, cry with rocking, poor sucking & feeding, in older child S+S of ICP Tx: Ventriculoperitoneal shunt, post op child is flat & may elevate slightly, strict I+O, and monitor for S+S of shunt infection!
Image of page 11
You've reached the end of this preview.
  • Winter '19
  • Melissa DuVall

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern