Neural tube defects are the most common congenital abnormality in India which can be easily prevented with due information and better nursing practices. Neural Tube Defects can be prevented with intake of folic acid.
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
Detailed Powerpoint Presentation on Wilms Tumour …. It includes definition with images, causes, sign and symptoms all treatment modalities with nursing responsibilities and recent research related to this...
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
Toxic shock syndrome is a serious, life threatening illness caused by toxins released by two specific bacteria Streptococcus pyogenes or Staphylococcus aureus
It is a medical emergency requiring prompt care
Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. An excessively large head at birth is suggestive of hydrocephalus.
Bulging of the anterior fontanelles. The anterior fontanelle becomes tense and bulging, the skull enlarges in all diameters, and the scalp becomes shiny and its veins dilate.
Setting sun sign. If pressure continues to increase without intervention, the eyes appear to be pushed downward slightly with the sclera visible above the iris- the so-called setting sun sign.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
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conclusions
Encephalitis is a rare yet serious disease that can be life-threatening.
Encephalitis is an inflammation of the brain tissue.
The most common cause is viral infections.
In rare cases it can be caused by bacteria or even fungi.
Encephalitis is an inflammation of the brain tissue.
Primary encephalitis- It occurs when a virus directly infects the brain and spinal cord.
Secondary encephalitis- It occurs when an infection starts elsewhere in the body and then travels to your brain.
Older adults
Children under the age of 1 year
People with weak immune systems
Primary (infectious) encephalitis
Common viruses, including HSV (herpes simplex virus) and EBV (Epstein-Barr virus)
Childhood viruses, including measles and mumps
Arboviruses (spread by mosquitoes, ticks, and other insects), including Japanese encephalitis, West Nile encephalitis, and tick-borne encephalitis
Secondary encephalitis: could be caused by a complication of a viral infection.
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
Toxic shock syndrome is a serious, life threatening illness caused by toxins released by two specific bacteria Streptococcus pyogenes or Staphylococcus aureus
It is a medical emergency requiring prompt care
Hydrocephalus
introduction
Hydrocephalus, also known years ago as “water on the brain”, is a condition where the circulation system of the body’s cerebrospinal fluid (CSF) is not functioning properly. The CSF accumulates in the brain and causes intracranial pressure. A shunt is usually placed to equalize the flow of CSF, which requires surgery. The diagnosis and surgery can be very frightening for the parents as well as the child
definition
Hydrocephalus is a condition characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity
INCIDENCE
It is found in 1-3 of every 1000 born children in world wide
Classification
Non communicating. In the non communicating type of congenital hydrocephalus, an obstruction occurs in the free circulation of CSF.
Communicating. In the communicating type of hydrocephalus, no obstruction of the free flow of the CSF exists between the ventricles and the spinal theca; rather, the condition is caused by defective absorption of CSF, thus causing increased pressure on the brain or spinal cord.
CAUSES
Obstruction. The most common problem is a partial obstruction of the normal flow of CSF, either from one ventricle to another or from the ventricles to other spaces around the brain.
Poor absorption. Less common is a problem with the mechanisms that enable the blood vessels to absorb CSF; this is often related to inflammation of brain tissues from disease or injury.
Overproduction. Rarely, the mechanisms for producing CSF create more than normal and more quickly than it can be absorbed.
PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
Poor feeding. The infant with hydrocephalus has trouble in feeding due to the difficulty of his condition.
Large head. An excessively large head at birth is suggestive of hydrocephalus.
Bulging of the anterior fontanelles. The anterior fontanelle becomes tense and bulging, the skull enlarges in all diameters, and the scalp becomes shiny and its veins dilate.
Setting sun sign. If pressure continues to increase without intervention, the eyes appear to be pushed downward slightly with the sclera visible above the iris- the so-called setting sun sign.
High-pitched cry. The intracranial pressure may increase and the infant’s cry could become high-pitched.
Irritability. Irritability is also caused by an increase in the intracranial pressure.
Projectile vomiting. An increase in the intracranial pressure can cause projectile vomiting
,
,
,
,
,
,
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,
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,
,,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
,
conclusions
Encephalitis is a rare yet serious disease that can be life-threatening.
Encephalitis is an inflammation of the brain tissue.
The most common cause is viral infections.
In rare cases it can be caused by bacteria or even fungi.
Encephalitis is an inflammation of the brain tissue.
Primary encephalitis- It occurs when a virus directly infects the brain and spinal cord.
Secondary encephalitis- It occurs when an infection starts elsewhere in the body and then travels to your brain.
Older adults
Children under the age of 1 year
People with weak immune systems
Primary (infectious) encephalitis
Common viruses, including HSV (herpes simplex virus) and EBV (Epstein-Barr virus)
Childhood viruses, including measles and mumps
Arboviruses (spread by mosquitoes, ticks, and other insects), including Japanese encephalitis, West Nile encephalitis, and tick-borne encephalitis
Secondary encephalitis: could be caused by a complication of a viral infection.
Spina bifida is a birth disorder that involves the incomplete development of the spine. In the first month of pregnancy, a special set of cells forms the “neural tube;” the top of the tube becomes the brain, and the remainder becomes the spinal cord and structures around it. In spina bifida, the neural tube doesn’t close completely and some of the bones of the spine do not close in the back. This can result in an opening anywhere along the spine and may cause damage to the spinal cord and nerves.There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele. The symptoms of spina bifida vary from person to person, depending on the type and level of involvement. Most cases are mild and do not require special treatment. The more serious cases involve nerve damage.
Occulta is the mildest and most common form in which one or more bones of the spinal column (vertebrae) are malformed. The name “occulta,” which means “hidden,” indicates that a layer of skin covers the opening in the bones of the spine. It usually shows no symptoms and is often found by accident on an x-ray or similar test.
Closed neural tube defects are a diverse group of disorders in which the spine may have malformations of fat, bone, or the membranes (the meninges) that cover the spinal cord. Many of these neural tube defects require surgery in childhood. People with this type of spina bifida may have weakness of the legs and trouble with bowel and bladder control. These issues may change or progress as children grow. It is important to have close communication with doctors to minimize these changes as much as possible.
Meningocele occurs when the meninges protrude through the spine and cause a sac of spinal fluid on the back. This fluid is typically only around the brain and spine, but a problem with the bony covering over the spine allows it to poke out. The malformation contains no nerves and may or may not be covered by a layer of skin. Individuals with meningocele may have minor symptoms.Myelomeningocele is the most severe form of spina bifida. A portion of the spinal cord or nerves are exposed in a sac through an opening in the spine that may or may not be covered by the meninges. The opening can be closed surgically while the baby is in utero or shortly after the baby is born. Most people with myelomeningocele experience changes in brain structure, leg weakness, and bladder and bowel dysfunction.
Myelomeningocele is often called a "snowflake condition" because no two people with the condition are the same. Typically, if the opening in the spine is lower down the back, the person will experience less symptoms. People with myelomeningocele require close follow-up with physicians throughout their childhood and lifespan to maximize their function and prevent complications like kidney failure.Complications of spina bifida may include:
Abnormal sensation or paralysis, which mostly occurs with closed neural tube defects and myelomenin
MYELOMENINGOCELE copy.pptx a slide describing the conditionAjisafeZainab
Myelomeningocele is a disorder of the nervous system particularly the spine and spinal cord, before we go further in this presentation there are some terms to know to aid understanding.
➢Neural tube; The neural tube forms the early brain and spine, As development progresses, the top of the neural tube becomes the brain, and the rest of the tube becomes the spinal cord. An NTD happens when this tube doesn't close completely somewhere along its length. Neural tube closure is completed 28 days (four weeks) from conception.
➢Alpha fetoprotein; AFP is a protein that the liver makes when its cells are growing and dividing to make new cells. AFP is normally high in unborn babies. After birth, AFP levels drop very low. Healthy children and adults who aren't pregnant have very little AFP in their blood. Maternal AFP serum level is used to screen for Down syndrome, neural tube defects, and other chromosomal abnormalities.
➢Spinal bifida; Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD).
Nursing management of myelomeningocele
Types of spinal Bifida
Pathophysiology of myelomeningocele
Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly. It falls under the broader category of NTD (Neural Tube Defects).
My name is Dahianara Moran and I believe being the parent of a child with Spina Bifida is like having a sixth sense, something like a Super Mom. We learn quickly how to defend our little ones from the awkward moments, but most important, we come to enjoy the little things, value our moments, and commit to change the way the world defines “Disability”.
Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly.
Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD). Spina bifida can happen anywhere along the spine if the neural tube does not close all the way.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
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How many patients does case series should have In comparison to case reports.pdfpubrica101
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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2. INTRODUCTION
The most common birth defect in India is Neural Tube
Defect.
The presentation of Neural Tube Defect may vary
from Anencepaly, spina bifida occulta and spina bifida
cystica.
In Year 2015 the birth prevalence of neural tube
defects in India was 4.5 per 1000 total birth.
3. Neural tube defects are birth defects of the brain,
spine, or spinal cord. It happens in the first month of
pregnancy, often before a woman even knows that she
is pregnant.
The two most common neural tube defects are
SPINA BIFIDA AND ANENCEPHALY.
In Spina bifida, the fetal spinal column doesn't close
completely.
In Anencephaly defect in brain development occur.
4. ETIOLOGY
The exact causes of neural tube defects are not known.
Genetic
Nutritional Factors
Environmental factors.
Poor intake of folic -acid (also known as folate)
Obese Women
Intake of anti epileptic medications during pregnancy
5. PATHOPHYSIOLOGY
THE NEURAL PLATE APPEARS ON THE 17TH DAY OF GESTATION
AS A THICKENING OF THE EMBRYONIC ECTODERM
.
ON DAY 18, THE NEURAL PLATE FOLDS ALONG THE MIDLINE
BY THE END OF THE THIRD GESTATIONAL WEEK, THE NEURAL
FOLDS FUSE TO FORM NEURAL TUBE.
.
…
.
.
.
6. FUSION BEGINS AT THE HINDBRAIN-CERVICAL JUNCTION FIRST
PROCEEDS ROSTRALLY AND THEN CAUDALLY
THEN, THE ANTERIOR AND POSTERIOR ENDS (NEUROPORES)
CLOSES TO FORM SPINAL CORD
DEPENDING ON THE POINT OF INTERUPPTION IN NEURAL TUBE
FORMATION DEVELOPS NTDS MAY AFFECT THE BRAIN
(ANENCEPHALY)OR SPINAL CORD (SPINA BIFIDA).
7. TYPES OF NEURAL TUBE DEFECTS
A Spinal cord defects
SPINA
OCCULTA
MENINGOCELE
A
9. COMMON TYPES OF SPINA BIFIDA
Spina bifida occulta which is the mildest form where
there is a small gap in the spine but the opening
cannot be seen in the back. Brain and spinal cord
functions are normal and there is no disabilities.
Meningocele is a sac of fluid not involving the spinal
cord that comes out through an opening in the back
and involve meninges also.
10. CONT……………
Myelomeningocele is one of the most common and
most severe form of spina bifida .
In this the unfused portion of the spinal column allows
the spinal cord to protrude through an opening,
forming a sac enclosing the spinal elements, such as
meninges, cerebrospinal fluid, and parts of the spinal
cord and nerve roots.
12. SIGN AND SYMPTOMS
Loss of bladder or bowel control
Partial or complete lack of sensation
Partial or complete paralysis of the legs
Weakness of the hips, legs, or feet of a newborn
Other symptoms may include:
Abnormal feet or legs, such as clubfoot
Build up of fluid inside the skull (hydrocephalus)
Hair present at sacral region
Dimpling of the sacral area
13. Brain Defects
Anencephaly is the absence of a major portion of
the brain, skull and scalp that occurs
during embryonic development. Infants with this
disorder do not survive longer than a few hours or
possibly days after their birth.
14. CONTD……
Encephalocele, sometimes known as cranium
bifidum, is a neural tube defect characterized by sac-
like protrusions of the brain and the membranes .
Symptoms may include
Neurologic problems
Hydrocephalus
Spastic quadriplegia
Microcephaly
15. DIAGNOSTIC TESTS
Ultrasound
Maternal serum Alpha feto protein at 16-20 weeks.
Aminiotic Alpha feto protein
Aminiotic acetyl cholineterase
16. MANAGEMENT
Medical Care
The patient should be positioned in the prone position
to prevent pressure on the defect.
The newborn with an open NTD should be kept warm
and the defect covered with a sterile wet saline
dressing.
Intravenous antibiotic should be initiated.
17. SURGICAL MANAGEMENT
Neurosurgical repair of the defect is considered the
mainstay of treatment for open spina bifida.
Closed spina bifida does not usually warrant any
immediate surgery.
The cele closure is typically performed within 1 to 3
days of delivery.
Neonates born with severe hydrocephalus should have
ventriculoperitoneal shunt placed concurrently.
18. NURSING MANAGEMENT
ASSESSMENT
Depends on the spinal involvement.
Visible spinal defect
Flaccid paralysis of legs.
Altered bowel and bladder pattern.
Perform neurological assessment
19. NURSING INTERVENTIONS
Evaluate the sac and measure lesion .
Monitor for increased ICP
Measure head circumfrence.
Protect sac with non adherent moist dressing
Place child in prone position
Use aseptic techniques
Monitor for early signs of infection
Administer Antibiotic.
Prepare Family for surgery
20. PREVENTION OF NEURAL TUBE
DEFECT
Experts recommend that all women of childbearing
age take a daily supplement of 400 micrograms (mcg)
of folic acid.
Educate mothers regarding intake of folic acid
especially in periconception period and in first
trimester as well.
Women already had first pregnancy with NTD should
take a daily 4mg tablet of folic acid for at least one
month before conception and then throughout the
first 12 weeks of pregnancy.
Genetic Counseling or screening.