Exam (elaborations)
NSG 317 Final Exam
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Exam of 9 pages for the course NSG 317 at NSG 317 (NSG 317 Final Exam)
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NSG 317 FINAL EXAM QUESTIONS WITHCOMPLETE SOLUTION
j Early s/s of neuro compromise r/t ICP for infants (13) - •Tense, bulging fontanel
•Separated cranial sutures
•Macewen (cracked-pot) sign
•Irritability and restlessness
•Drowsiness
•Increased sleeping
•High-pitched cry
•Increased sleeping
•Increased fronto-occipital circumference
•Distended scalp veins
•Poor feeding
•Crying when disturbed
•Setting-sun sign
Early s/s of neuro compromise r/t ICP for children (11) - •Headache
•Nausea
•Forceful vomiting
•Diplopia, blurred vision
•Seizures
•Indifference, drowsiness
•Decline in school performance
•Diminished physical activity and motor performance
•Increased sleeping
•Inability to follow simple commands
•Lethargy
, When is autonomic activity most intensively disturbed in children with IICP? - Deep coma or brain stem
lesions
What is the effect if IICP on body temperature - Often it is elevated, sometimes to extremes.
Certain infections or hypothalamic involvement may cause a decrease.
Effect of IICP on pulse pressure - It can vary. Bounding, rapid, slow, or feeble.
Effect of IICP on BP - May be high, low, or normal
What is the normal RR for a child with IICP? - Slow, deep, and irregular
In the child with IICP, what happens to the RR when the patient is on sedatives? - It becomes shallow
In the child with IICP, what is the cause of hyperventilation? - Metabolic acidosis or abnormal stimulation
of the respiratory center inn the medulla.
In the child with IICP, what respiratory pattern is an indicator of brain stem dysfunction? - Periodic or
irregular breathing which often precedes complete apnea.
What skin symptoms should the nurse check for when evaluating the child with IICP? - Color,
temperature, turgor, signs of insect bites, injury, needle marks, petechiae, and ticks.
What should the nurse assess regarding the eyes of the child with IICP? - Pupil size and reactivity
What do pinpoint pupils usually indicate in the patient with IICP? - Brain stem dysfunction or poisoning
What eye manifestation indicates a neurologic emergency? - The sudden appearance of fixed and dilated
pupils
When observing motor function in the patient with IICP, how should the nurse chart it? - With the use of
descriptions rather than labels/terms.
In cases of hemiplegia, how do the affected limb(s) lie? - In external rotation. If lifted and allowed to
drop, it will fall uncontrollably.
What motor abnormalities suggest paralysis in the patient with IICP? - Asymmetric or absence of
movement.
What motor functions should the nurse observe for in the patient with IICP? - Spontaneous activity, gait,
and response to painful stimuli.
What are reflexive indications of brain dysfunction in the patient with IICP - Emergence of primitive
postural reflexes which occur as cortical control is lost.
Decorticate or flexion posturing - Rigid flexation of arms/elbows/wrists/feet. Legs extended/internally
rotated. Caused by dysfunction of cerebral cortex or lesions to corticospinal tracts above brain stem.
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