My shiny padlet by Disseminated Intravascular Coagulation (DIC) https://padlet.com/avital6536/pfqk7803ybkwfj7e Made by Carla McCann, Juanita Quintana, Mackey Roth, Agathe Vital, Nancy Zamora en-us 2020-07-15 04:34:54 UTC 2020-07-19 22:48:31 UTC hello@padlet.com Monitor the followings: avital6536 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656198471
  • Respiratory status 
  • Evidence of seizure activity
  • Speech ability
  • Visual and auditory acuity
  • Pain level and effectiveness of interventions
  • Swallowing function
  • Reflexes
  • Nutritional status
  • Skin integrity, especially under braces and splints
  • Motor development
  • Muscle strength
  • Overall growth and development and achievement of developmental milestones
    • (Lippincott Advisor, 2020)
    ]]>     2020-07-16 17:00:36 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656198471     The Nurse should: avital6536 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656200980
  • Auscultate lung sounds for changes. 
  • Institute safety precautions to provide a safe physical environment. 
  • Initiate seizure and fall precautions. 
  • Assess for difficulty with swallowing. Consult with a speech therapist for appropriate measures.
  • Provide a diet with adequate calories.
  • Administer parental nutrition if appropriate.
  • Measure intake and output.
  • Speak slowly and distinctly, making sure to face the patient.
  • Provide all care in an unhurried manner.
  • Allow participation in care decisions. Foster the patient's sense of control over the situation.
  • Administer prescribed medications such as baclofen to reduce spasticity.
  • Provide frequent mouth and dental care.
  • Provide meticulous skin care, especially to areas of pressure such as under braces or splints.
  • Assist with the application of braces or splints or the use of assistive devices, as necessary.
  • Perform prescribed exercises to maintain muscle tone.
  • Care for associated hearing and vision disturbances, as necessary.
  • Prepare the patient and family for possible surgery; postoperatively, give analgesics for pain relief, as ordered.
  • Consult with physical and occupational therapists, as appropriate, to maximize the patient's functional capacities.
    • (Lippincott Advisor, 2020)
    ]]>     2020-07-16 17:04:03 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656200980     Management of CP carlamccann24 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656339314 Evaluation of function
    o   This is an important role in planning treatment because it is based on limitations with regards to the client’s structure and function
    o   Standardized measurements of function test include:
    • Gross Motor Function Classification System (GMFCS)
    • Modified Ashworth Scale
    • Manual Ability Classification System (MACS)
    • Communications Function Classification System (CFCS)

    Management of Spasticity

    o Botulinum type A is inserted by injection into affected muscles
    • It is given every 3-8 months to maintain effectiveness.
    • It is typically seen used in the calf muscles of clients who have diplegia or hemiplegia.
    • It is given to children who have greater muscle mass that decreases function, especial with growth that are likely to cause contractures. 
    o   Antispastic drugs
    • These are given orally and are not as effective as Botox. 
    • They include: 
      • Benzodiazepines (Diazepam)
      • Dantrolene
      •  Baclofen 
        • This medication can also be given via an implanted pump in the abdomen that delivers directly to the spinal cord
        •  It can also be given intrathecally to achieve higher drug levels within cerebral spinal fluid (CSF)

    Surgical Treatments
    • Selective dorsal rhizotomy (SDR)
      •  This surgery is the main intervention to treat spasticity  
      • See YouTube video below
    •   Deep brain stimulation (DBS)
      • This is a newer therapy and is being researched in the treatment of dyskinetic cerebral palsy. It was previously used in treatment for adults with severe primary dystonia that did not respond well to pharmacotherapy.

    Orthopedic Interventions
    • Gait analysis
    • Ankle-foot orthoses
    • Casting
    • Muscle-tendon surgery
    • Surgical treatment for hip disorders

    Physical Therapy
    • Physical therapy 
      • is a key component of treatment and management 
    • Bi-manual training 
    • Constraint-induced Movement Therapy (CIMT)
    • Context-focused therapy
    • Goal directed/functional training

    Management of Drooling
    • Anticholinergic medications
      • Benhexol hydrochloride
      • Scopolamine
      • Glycopyrrolate
    • Botox injections into salivary glands
    • Surgical treatment
    • Behavior management techniques
    • Biofeedback techniques

    Management of osteopenia
    • Biphosphonates

    Management of urinary incontinence
    • Anitcholinergic medications
    • toileting schedule modifications
    • intermittent catheterization 

     (Nettina, Lippincott Manual of Nursing Practice 2019) 


    ]]>     2020-07-16 20:20:35 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656339314     What is it? nzamora0553 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656409646 Cerebral Palsy is a combination of disorders that is non-progressive involve motor  disabilities, movement, balance and posture. Resulting from brain damage during prenatal, perinatal or postnatal a lifelong condition. It is usually diagnosed after the 2nd year of birth. Cognitive impairment not always involved depends on the location of damage in the brain.
    (Pearson, 2019).]]>     2020-07-16 22:24:08 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/656409646     Spastic Cerebral Palsy mroth20715 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657175940
  • Most common
  • Caused by an injury to the upper neurons of the pyramidal tract
  • Hypertonicity 
  • Permanent contractures 
  • Hyperreflexia
  • Movement, posture, and balance are poorly controlled
  • Babinski reflex 
  • Truncal hypotonia present during first year of life
  • May walk on outside of feet or tip toes 

    • Dyskinetic Cerebral Palsy
         -Athetoid 
    • Caused by basal ganglia injury 
      • May be associated with kernicterus due to high levels of bilirubin 
    • Involuntary movements are abnormal in all extremities, head, and eyes
    • Normal cognitive function
    • Seizures may occur
    • Stress can increase movements
    • Dysarthria 
    • Movements may be worm-like or twisting
    -Dystonic 
    • Rare
    • Muscle tone is decreased
    • Stiff movement 
    • Reduced activity

    Ataxic Cerebral Palsy 
    • Caused by injury to cerebellum 
    • Rare
    • Balance, depth perception, and voluntary movements are abnormal 
    • Normal cognition 
    • Coordination is poor and falls are likely to occur
    • Unsteady and wide-based gait

    Rigid form of Cerebral Palsy 
    • Uncommon
    • Poor prognosis
    • Little movement
    • Deformities 
    • Tremors
    • Atonic 

    Mixed form of Cerebral Palsy 
    • Occurs when there is more than one type of motor pattern present
      • No motor pattern significantly dominates the other
    • Complications:  
      • Seizure
      • Cognitive-perceptual  impairments
      • Difficulties with senses 
    • Common form is athetoid and spastic 

    Manifestations of Cerebral Palsy
    • Different presentations
    • Poor balance and posture
    • Uncontrollable movements
    • Irregular muscle tone
    • Primitive reflexes 
    • Impaired sensations
    • Dysarthria 
    • Dysphagia 
    • Trouble concentrating 
    • Seizures 
    • Hemiplegia- one side of the body is affected
    • Paraplegia- both legs are affected
    • Quadriplegia- all extremities are affected
    (Carman, 2016, p. 1713)
    (Massey, 2020)

    ]]>     2020-07-17 21:38:26 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657175940     avital6536 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657372585 2020-07-18 08:37:08 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657372585 avital6536 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657493684 2020-07-18 17:48:32 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657493684 avital6536 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657496475 2020-07-18 17:59:30 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657496475 carlamccann24 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657524066 Carman, S.R. K. (2016). Lippincott CoursePoint for Ricci, Kyle & Carman: Essentials of Maternity, Newborn and Women's Health Nursing. (3rd ed.). Retrieved from https://coursepoint.vitalsource.com/#/books/9781469898162/

    Cerebral Palsy Diagnosis. (n.d.). Retrieved July 19, 2020, from https://www.cerebralpalsy.org/about-cerebral-palsy/diagnosis

    CP Family Network. (2020). CPFN. CPFN. https://cpfamilynetwork.org/

    Lippincott Advisor for Education. (2020, July 10). Cerebral palsy. Retrieved July 18, 2020, from https://advisor-edu.lww.com/lna/document.do?bid=4

    Massey, M. (2020). Mobility HCC III [PPT].

    Nettina, S. M. (2019). Cerebral Palsy Management . In Lippincott manual of nursing

    Pearson. (2019). Nursing : a concept-based approach to learning. Volume 2. (3rd ed.). Pearson.
    ]]>     2020-07-18 19:49:13 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657524066     RISK FACTORS avital6536 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657609959
  • Infection during pregnancy, especially varicella, rubella, cytomegalovirus, toxoplasmosis, syphilis, herpes
  • Exposure to toxins during pregnancy, such as mercury
  • Other conditions during pregnancy, such as seizures, thyroid problems
  • Premature birth, low birth weight, breech delivery, multiple fetus delivery
  • Infant illness, such as bacterial meningitis, untreated severe jaundice, viral encephalitis
    • (Lippincott Advisor, 2020)

    ]]>     2020-07-19 02:26:27 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657609959     Know that there is no manual for Cerebral Palsy care, but here are some guidelines: juaniquinta https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657610336
  • As the caregiver, the care you give to the patient depends on your health and well being, Take care of YOU!
  • Have a good support network to give you positive encouragement, helpful advice, somebody to vent to,  to let you know that your stress is normal
  • Look for Cerebral Palsy websites that provide updated and mutual experiences shared by other parents/caregivers such as
  • Cerebral Palsy Foundation: yourcpf.org
  • Cerebral Palsy.org: http://cerebralpalsy.org/
  •  United Cerebral Palsy: http://www.ucp.org
  • Cerebral Palsy Family Network: http://cpfamilynetwork.org/

    • Use a Care Giver organizer as a communication guide for other family members, other care givers and for referencing at medical and therapy appointments

    ]]>     2020-07-19 02:28:07 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657610336     Cerebral Palsy Family Network Webisode juaniquinta https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657630709 Informative additional resource available on one CP website that includes mothers sharing their personal experiences.]]> 2020-07-19 03:58:24 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657630709 Family education about the patient includes: juaniquinta https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657631313
  • Know what type of CP the patient has and customize their care accordingly
  • Know the patients medicine, how they work, what they are for, how they are given,  and their side effects
  • Know what adverse effects to look for, when and who to report them to
  • Monitor skin daily for redness, abrasions,  indentions, changes that appear abnormal due to the splints or braces that are worn
  • Know how to apply splints and braces properly
  • Work with professional resources such as therapy to develop a safe and therapeutic massage regimen for the patient
  • Know that your child's developmental milestones will be different then children without CP
  • Exercise and ROM will help with spasticity, muscle stretching for joint flexibility
  • Learn seizure precautions
  • Encourage independence and social skills with adaptive utensils, toys, playgroups
  • Keep all appointments with physical and rehab therapist for congruent care
  • In regards to nutrition work with a nutritionist to identify the recommended caloric intake and proper diet for growth and development
  • Work with a speech therapist to develop the proper food and drink consistency the patient can safely tolerate 
  • Understand the safety measures for swallowing food properly to avoid aspiration
  • Learn to monitor respiratory status to avoid aspiration pneumonia
  • Do involve siblings in care appropriately
    • (Lippincott Advisor, 2020)
    (Pearson, 2019)
    (Cerebra Palsy Family Network, 2020)
    ]]>     2020-07-19 04:01:17 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657631313     LABS & DIAGNOSTIC PROCEDURES avital6536 https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657891404
  • There is no test that confirms or rules out Cerebral Palsy. Genetic testing, blood work and urinalysis can be done to rule out other diseases.
  • Computed tomography scanning of the brain and magnetic resonance imaging may show structural abnormalities of the brain, such as cerebral atrophy.
  • Electroencephalography may show the source of seizure activity.
  • Test results may not be conclusive until the brain is fully developed somewhere between 3 to 5 years of age.
    • (cerebralpalsy.org)
    (Lippincott Advisor, 2020)

    ]]>     2020-07-19 21:58:25 UTC https://padlet.com/avital6536/pfqk7803ybkwfj7e/wish/657891404