Discuss the differences between the nervous system of a child and an adult.
Discuss the differences of the newborn’s ear versus an adult’s ear. Discuss how the eustachian tube functions. Audience Response Question #1 Breastfed infants are less likely to get middle ear infections than formula fed infants. 1. True 2. False
Demonstrate how to measure ear alignment. What is the significance of ear alignment?
Discuss the instillation of a wick after instilling drops.
What is the reason for increased incidence of OM in infants versus older children?
Discuss the pathophysiology of these signs and symptoms.
Which surgical procedures which would assist in treating chronic OM?
Discuss how chronic ear infections could cause hearing impairment. Discuss how cerumen can safely be removed from the ear canal.
What behaviors might a child with hearing impairment exhibit?
Give an example of situations in which a nurse or parent can assess hearing response in an infant. Discuss the method of insertion and function of cochlear implants.
What are examples of visual aids that could enhance communication? Give examples of body language that an infant and toddler could understand.
Discuss the rationale for communicating at eye level and face-to-face with the child. Why might exaggerated face or lip movements hinder communication?
Yawning, chewing gum, or sucking on a bottle will help prevent this from occurring when descending in an airplane. Decongestants can also be taken, but must be taken at a time to ensure they are at their peak effect when needed for descent. Discuss how underwater diving can cause organisms to migrate to the middle ear due to the pressure. Descent should be slow to allow for equalization of pressure. Sensory hearing loss and vertigo with nausea and vomiting may be an early sign of decompression sickness when it occurs during the ascent phase of diving. Diver should be referred for medical care.
Discuss how objects might appear to a newborn. Discuss depth perception.
Discuss the Snellen “E” chart. How is the Timus machine used?
Discuss signs and symptoms that a child with dyslexia might exhibit. How could remedial instruction assist the child with dyslexia?
Discuss strabismus. When abnormal binocular interaction occurs (in strabismus), the prognosis depends on how long the eye has been affected and the age of the child when treatment begins. Occurs as a result of sensory deprivation of the affected eye, children are at risk for developing the problem until visual stability occurs, usually around 9 years of age. Discuss the nurse’s role in assisting the child and family with this disorder.
Discuss the surgical procedure.
Give an example for each of the nursing interventions.
What is the rationale for warm compresses? Audience Response Question #2 Once started on pharmocological treatment for bacterial conjunctivitis, the child can return to school: 1. immediately. 2. in one week. 3. as soon as symptoms subside. 4. after 24 hours have passed.
In what situations could a child experience an eye injury?
Describe the cat’s eye reflex.
Discuss the pathophysiology which causes ALOC in the postictal state.
Discuss methods to maintain a patent airway. Discuss typical diagnostic and routine labs to obtain for a child with this condition. Toxic levels of ammonia cause cerebral manifestations, such as ALOC, behavioral changes, seizures, and coma.
What are signs and symptoms of multiorgan dysfunction syndrome?
In infants, septic shock is not diagnosed by a decrease in BP because initially the infant’s body compensates for the poor circulation and tissue perfusion by increasing the heart rate and vasoconstriction of peripheral blood vessels. Hypotension in an infant is an ominous sign that may indicate the body is no longer able to compensate adequately and cardiorespiratory arrest is about to occur.
What methods help prevent or limit a child’s exposure to these organisms? Peak incidence for bacterial meningitis is 6 to 12 months of age. Less common in children older than 4 years of age.
Discuss the pathophysiology behind the signs and symptoms.
Discuss neurological assessment. What is the rationale of decreasing environmental stimuli?
Discuss the difference between meningitis and encephalitis.
Discuss nursing interventions which are supportive and relieve symptoms. What are some examples of seizure precautions?
Discuss nystagmus and papilledema. Discuss signs and symptoms: Intracranial pressure (ICP) Headache Vomiting Drowsiness Seizures Nystagmus Strabismus Papilledema Ataxia Head tilt Behavioral changes In infants, cerebral enlargement
Audience Response Question #3 If the nurse witnesses a child begin to seize, the first action should be to: 1. note the start time. 2. assess vital signs. 3. ensure safety. 4. insert tongue blade.
With which potential drugs and poisons might a child come into contact?
Discuss and give examples of the difference between generalized and partial seizures. Describe the three phases of generalized seizures. Aura Tonic/clonic seizure Postictal Audience Response Question #4 The higher the fever the increased risk of febrile seizure. 1. True 2. False
Discuss the nurse’s role regarding medications: Drowsiness common side effect Take medications at same time every day Do not stop drug suddenly as it can cause status epilepticus (prolonged seizures) Discuss the nurse’s role regarding diet: Ketogenic diet—high in fats and low in carbohydrates—produces ketoacidosis, which appears to reduce convulsive episodes
Discuss the child’s role in the treatment plan.
Discuss each condition.
Discuss precipitating factors and the pathophysiology which contributes to CP.
Give examples of mild and severe forms. What milestones might be delayed for an infant and toddler with this condition?
Discuss the pathophysiology regarding botulinum toxin to manage spasticity. Discuss criteria which would provide a supportive environment for a child with CP.
Give examples of technological devices which can promote growth and development.
What is the typical IQ of a child with mental retardation? Discuss the particular aspects of each element involved in mental functioning. Level of consciousness: Attention Short-term memory Long-term memory Perceptions Thought processes Insight Judgment Affect Mood Expressive language Vocabulary Abstract thinking Intelligence
Discuss the Stanford-Binet test.
Discuss the pathophysiology regarding these causes.
What are some situations in which a cognitively impaired child’s psychosocial needs might not be met? Discuss methods to meet the impaired child’s needs.
Give an example of a situation in which parents might help their child to become successful.
Discuss how the nurse can assess the child’s stage of maturation and ability. Discuss self-help activities which the nurse can promote in a child with this disorder.
Discuss labels that should be avoided.
Review Table 23-5 on page 553.
Give examples of situations that could cause head injuries in the infant. How could a child’s response differ from an adult who has experienced a head injury?
Discuss the pathophysiology.
Discuss signs and symptoms of increased ICP and cerebral edema.
Discuss these postures and the area of injury in the brain.
Discuss assessment of each of these components.
Give examples of subtle changes the nurse might miss in a child who shows improvement.
Discuss methods for assessing each component.
What neurological deficits might this child exhibit?
Chapter 23 Power Point
Chapter 23Chapter 23
The Child with a Sensory orThe Child with a Sensory or
Neurological ConditionNeurological Condition