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[...]... affect thepatient s long-term prognosis and ultimate quality of life Care planning should be a team approach that involves the parents and the multidisciplinary team to assure optimal outcomes Factors that impact the assessment will be the age ofthe child, the family dynamics, the nature ofthe child’s illness, the setting in which the assessment takes place, and input from other member ofthe multidisciplinary... performed by the bedside nurse, but they are important to the assessment ofthe function of CN II If the child is awake and able to cooperate, the examiner will position themselves about 2–3 feet (6– 9 m) in front ofthepatient and have thepatient look directly at their nose while bringing a brightly colored object from the periphery (right, left, upper, and lower) into the central visual area The child... Accurate measurement of occipital-frontal circumference is vital If the child is unconscious, careful placement ofthe tape while thepatient is supine is important In children under the age of 2 years with a normally shaped skull, this measurement is taken just above the eyes and over the occipital ridge Palpation ofthe scalp is done to look for any alteration in the skin integrity ofthe scalp and to... Appearance The neonatal period is often defined as the first 4 weeks of life The neonate may be term or premature and the physical characteristics of neonates vary with their gestational age Inspection ofthe shape, symmetry, and mobility ofthe head ofthe neonate is critical for evaluating cranial abnormalities or soft tissue injuries Head circumference at term will range from 34 to 36 cm, within the 25–75%... observation ofthepatient s spontaneous movements, as well as responses to direct commands and to tactile stimuli Key things to observe are the presence of any asymmetries of movement or unusual postures of either the upper or lower extremities The overall bulk ofthe muscles and tone is important, especially if there is any question of limb atrophy In infants, testing of primitive reflexes like the Babinski,... either a sharp object or crushed ice in a glove The examiner first confirms the sensation ofthe chosen stimulus on a part ofthe body with normal sensation, then uses the stimulus on the affected area and asks the child to compare with what they have confirmed is “normal.” Both anterior and posterior levels are pictured on the chart, which should be readily accessible to nurses who care for these patients... After then, the response is considered abnormal and should be documented, and any asymmetry noted [33] Gait and balance are controlled in part by the cerebellum Assessment of cerebellar function includes the ability to move limbs smoothly in space and the steadiness ofthe gait The extent ofthe assessment of a child’s gait and balance will depend on the ability ofthe child to cooperate with the assessment... developmental age ofthe child, which, if different from the chronological age, will impact the assessment and patientcareofthe child This developmental information can guide the nurse in planning for the child’s home care, including targeted resources such as early intervention services, adapted educational plans, rehabilitation and therapy services Hands-On Neurological Assessment The importance ofthe well-documented... resection in the area ofthe temporal lobe is often proximate to, or overlaps with, the optic nerves as they project from the retina in a posterior fashion to the occipital lobe [28] Fundoscopic examination in the acute setting is utilized to look for evidence of papilledema and/or retinal hemorrhages The former is a sign of IICP, generally of a gradual and long-standing nature The latter is a sign of traumatic... of testing hearing is to hold a ticking watch or rubbing strands of hair together near the child’s ear and ask if they can hear the sound and describe what it is they are hearing Three ofthe lower cranial nerves, the glossopharyngeal, vagus, and hypoglossal nerves (CNs IX, X, and XII, respectively), are often referred to as a whole in the clinical setting because of their roles in swallowing and the . w0 h0" alt=""
Contents
Nursing Care of the Pediatric
Neurosurgery Patient
Contents
Nursing Care
of the Pediatric
Neurosurgery
Patient
Cathy C. Cartwright. the love and understanding of
my family and friends, which includes my son James.
D.W.
Contents
Foreword
Nursing care of the pediatric neurosurgery patient