PEDS

HCP Hydrocephalus
Increase production, decrease absoption of CSF in the ventricular system.
Clinical Manisfestations:
Headache improves when sittign upright
Strabismus
Irritable
Lethargy
Cries when picked up or rocked and quiet when laid down
Shrill high pitched cry
Vomiting
EARLY (infancy)
-rapid head growth
-bulging fontanels (Tense and nonpalsatile)
-Dilated scalp viens
-Separted sutures
-Thin skull bones
LATE:
-Frontal enlargement
-Depressed eyes
-Setting sun( sclera visible above iris)
-Pupils sluggish and unequal to light

Cx an increased intracraninal pressure, resulting in dilation of ventrilces.
Mainly occur at the sagittal suture of children younger than 12.
DX: measure head circumference for increasing size over 2-4 weeks with neourological signs
MRI and CT scan
TX: Sugical treatment removal of tumor or placing a shunt.
Massive doses of ABX to prevent CNS infection
CSF drains monitor output and don’t remove dsg for any reason
Interventions:
Moitor for IICP  meausing head paplate fontanels
VS/LOCFeeding pattern
Postion of unoperate side
Lay flat
HOB elevated 30 degress
Head midline facilate drainage and prevent JVD

REYE’s SYNDROME:
Toxic encephalopathy, with organ involvement
Cx: Taking aspirin during a viral infection commonly flu and varicella
Dx: elevated ammonia level
S/S:
Fever
Impaired consciousness
Decresed hepatic function
*Cerebral edema with IICP*
TX: Lumbar puncture, blood tests, monitor I&Os ( dehydration or cerebral edema risk), monotir for hypovolemic shock, liver dysfuction impaired coagulation ( prolonged bleeding times)
FEBILE SEIZURE:
Tempeture reaches 101.8, seizures occur when temp increased not after.
Most children will not have epilepsy or neurologic damage
Occurs between 6 months and 3 years old
Common in male
TX:
Antipyretics
Diazepam rectually
Prophylaxis if focal or prolonger sizure occur
No tepid baths
Call 911 if seizure last longer than 5 mins