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ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM

ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM. Pediatric Disorders. Cerebral palsy. Cerebral Palsy(CP)is characterized by: - impaired movement & posture -lack of motor control over voluntary muscles -r/t lesions in the brain. Cerebral Palsy. Population at risk:

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ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM

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  1. ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM Pediatric Disorders

  2. Cerebral palsy • Cerebral Palsy(CP)is characterized by: - impaired movement & posture -lack of motor control over voluntary muscles -r/t lesions in the brain

  3. Cerebral Palsy • Population at risk: - intrauterine infections during pregnancy -complicated labor & delivery(hypoxia) -prematurity and/or low birth weight • Incidence: -800,000 in US -10,000 births each year • http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm

  4. CLINICAL MANIFESTATIONS • Universal Symptom: delayed gross motor development • Abnormal motor performance • Alterations muscle tone: rigidity, stiffness • Abnormal postures: scissoring • Reflex abnormalities: persistance of primitive infantile reflexes

  5. ASSOCIATED DISABILITIES • May have mental retardation • Common to have seizures • Attention deficit/hyperactivity • Sensory impairment

  6. CLASSIFICATION • Spastic: increased muscle tone • Dyskinetic (athetoid): abnormal writhing movements, drooling, dysarthria, • Ataxic: difficulty with balance • Mixed: athetoid and spastic

  7. DIAGNOSIS • Know normal growth and development • Observe in newborn nursery • Early recognition important

  8. TREATMENT • TEAM APPROACH Goals: • Establish locomotion, communication, self-help • To gain optimum function • To correct associated defects • To provide educational opportunities

  9. ADAPTIVE/ASSISTIVE TECHNOLOGY • Braces • Ambulation devices • Scooter boards • Wheeled go carts • Computers • Adaptive utensils

  10. NURSING CARE 1.FEEDING: • Position child upright for feeding • Place foods far back in the mouth • Gentle upward stroking of the neck 2.PROVIDE ADEQUATE DIET: high calorie diet 3. MAINTAIN SKIN INTEGRITY 4. PROMOTE SELF-CONCEPT

  11. NURSING CARE CONTINUED 5. FOSTER PARENTAL KNOWLEDGE 6. USE THE PARENTS AS BEST RESOURCE 7. PROVIDE REST 8. PREVENT/TREAT RESPIRATORY INFECTIONS 9. MAINTAIN DENTAL HYGIENE

  12. SURGICAL INTERVENTIONS • Orthopedic • TAL (tendon achilles lengthening) • release of tight wrist and hip muscles

  13. Medications • Purpose -to control seizures (dilantin, topamax, phenobarbitol) -to control spasms (skeletal muscle relaxants, baclofen) -to minimize GI side effects (reglan, zantac)

  14. NURSING DIAGNOSES • Impaired Physical Mobility r/t decreased muscle strength and control • Disturbed Sensory Perception r/t cerebral damage • Risk of constipation r/t decreased intake of fiber and fluids

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