HESI PEDS Neuromuscular

Common associated problems of Down Syndrome
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Terms in this set (33)
HESI HINT: For infant/child w CP, a major focus should be on preventing aspiration in was such as:Sit child upright Support lower jaw Keep child upright after feedsAdministering safety precautions for a child w CP includes:Prevent aspiration Seizure precautions Helmet (if child is prone to falls)Some medications that may be prescribed to a child w CP includesAnticonvulsant meds (Ex. Phenytoin/Dilantin) Muscle spasm meds (Ex. Diazepam/Valium)Spina Bifida (Neural tube defect) is a malformation of the ___ & ____ resulting in varying degrees of disability/deformity depending on the location of the malformationVertebrae & spinal cordA type of spina bifida in which it is a defect of the vertebrae ONLY; no sac is present & is usually a bening conditionSpina bifida occultaAlthough usually a benign condition, spina bifida occulta may have what kind of problems?bowel and bladder problemsIn these types of spina bifida, a sac is present at some point along the spine?Meningocele & myelominingoceleType of spina bifida in which a sac is present, and it only contains meninges & spinal fluid; has less neuro involvement than the otherMeningoceleType of spina bifida (most severe) & involves a sac that contains spinal fluid, meninges, & NERVESmyelomeningoceleWomen in child bearing years (during and before pregnancy) are advised to consume a minimum of what to prevent spina bifida400 mcg of folic acidFoods high in folic acidEggs Dark green veggies Citrus fruits Juices BeansEvery child w a history of spina bifida should be screened for what allergy?latexAssessment findings for spina bifida occultaDimple (w or w out hair tuft) at base of spine Continence issuesAssessment finding of sac in myelomeningocele (location)lumbar/lumbar sacralNursing assessment of spina bifidaFlaccid paralysis Limited or no feeling below defect Head circumference at variance w normsCommon problems associated w spina bifida (6)1. hydrocephalus (90% w myelomeningocele) 2. Neurogenic bladder, poor anal sphincter tone 3. Congenital dislocated hips 4. Club feet 5. Skin problems (associated w anesthesia below defect) 6. ScoliosisPreoperative positioning for a child w spina bifida (position of foot of bed, legs, etc.)prone position; child should be placed on abdomen w legs abducted; FOOT of bed should be elevatedWhen caring for a child w spina bifida preoperatively, a nurse should frequently measure & check?Head circumference (at least q8h) or every shift; check fontanelPre operative care of sac from spina bifidaCovered w a moist sterile (Normal saline, NONadherent dressing) to maintain moisture & sac contents; chx whenever soiledUntil the defect (sac in spina bifida is repaired) _____ may be contraindicateddiaperingPreoperative care of a child w spina bifida may involve emptying the child's bladder by ______ or _____Crede method or catheterizationPosition of child w spina bifida postoperativelyProne positionWhat drugs might you administer to a child w spina bifida to help improve continence?Propantheline (Pro-Banthine) Bethanechol (Urecholine)