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NUR 436 Exam 2 Questions with Latest Update
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NUR 436 Exam 2 Questions with Latest Update
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NUR 436 Exam 2 Questions with LatestUpdate
what are the symptoms of increased ICP in an infant and child - Answer-INFANT
i. tense fontanel with increasing head circumference
ii. irritable with high-pitched cry
iii. poor feeding
CHILD
i. headache
ii. nausea/forceful vomiting
iii. vision changes
iv. lethargy
LATE SIGNS
i. pupillary changes with papilledema present
ii. decreased consciousness/motor responses
iii. Cushing triad
1. decreased HR
2. increased BP
3. periodic breathing
Acute inflammation of the meninges and cerebrospinal fluid.
Bacterial infection causes inflammation, exudation, and white blood cell accumulation in
the subarachnoid space of the CNS→may obstruct the flow of CSF further↑ICP. -
Answer-bacterial meningitis
how is bacterial meningitis diagnosed - Answer-i. LP CSF shows cloudy fluid with
increased WBC (neutrophils), increased protein, decreased glucose
ii. Increase in opening pressure Gram stain/culture will be + and identify organism
diagnose a child with these s/sxL seizures, pain (headache or muscle). child up to 2
years: anorexia, high pitched cry, vomiting, bulging fontanel. child over 2 years: chills
and vomiting, change in mental status/agitation and irritability, nuchal rigidity, positive
Kernig and Brudzinski signs, photophobia - Answer-bacterial meningitis
what nursing diagnoses would be appropriate for bacterial meningitis - Answer-- risk for
infection
- impaired comfort
- decreased cerebral adaptive capacity/ risk for injury: seizure
- risk for fluid/electrolyte imbalance
how would you treat bacterial meningitis - Answer-i. Analgesic
ii. Antipyretics
iii. Prompt antibiotic therapy (meningitis level dosing)
iv. Droplet precautions for first 24 hours of therapy
, v. Corticosteroid to decrease inflammation
Prevent long-term disabilities
1. Seizures --> antiepileptic/antibiotic therapy
2. Osmotherapy→3% saline/diuretic for ↑ ICP
3. DI give DDAVP (intranasal/IV)
4. SIADH w/fluid restriction + Na supplement
Acute inflammatory process of the brain from direct invasion of the CNS or post-
infectious involvement - Answer-viral encephalitis
how do you diagnose viral encephalitis - Answer-CT/MRI, LP with viral PCR
diagnose a child with these s/sx: headache, nuchal rigidity, tremors to ataxia, lethargy,
seizures, poor feedings, speech difficulties to mutism, ocular palsies, paralysis -
Answer-viral encephalitis
what nursing diagnoses would be appropriate for viral encephalitis - Answer-- fluid
imbalance/ nutrition < body requirements
- risk for infection
- decreased cerebral adaptive capacity/risk for injury: Seizure
- impaired mobility/communication
how would you treat viral encephalitis - Answer-i. PT/OT/speech with rehabilitation for
residual defects
ii. Antiviral agent (herpes simplex only)
Prevent long term disabilities
1. Seizures àantiepileptic
2. Osmotherapy à3% saline diuretic
3. Pain management
iv. IV/NG hydration
Acute metabolic encephalopathy following viral infection in which aspirin was used.
Mitochondrial dysfunction → fatty acid metabolism disturbances → fatty liver (liver
dysfunction) and cerebral edema - Answer-reye syndrome
how do you diagnose reye syndrome - Answer-CT
diagnose a child with these s/sx: fever, profuse vomiting, hepatic dysfunction (high Pt,
PTT, and ammonia, palpable hepatomegaly, liver biopsy performed), profound impaired
consciousness with cerebral edema - Answer-reye syndrome
what nursing diagnoses are appropriate for reye syndrome - Answer-- impaired
comfort/fluid volume deficit
- decreased cerebral adaptive capacity: risk for injury: seizure
- risk for injury: bleeding
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