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CASE STUDY

Dr. amaal
Amjad alanazi
Khawlah abdulaziz
Hind almubarki
Maha alhzazi
Ahlam almajrashi

OUT LINE : Definition • case components • background in formation • HEALTH HISTORY • PHYSICAL ASSESSMENT • diagnostic procedure • Medication • Management • Nursing Interventions • health education : • .

Babies born prematurely or at low birth weights are at higher risk The disorder is usually caused by brain injuries that occur early in the course of development Cerebral palsy isn't curable. or rigid and stiff . Cerebral palsy can cause muscles to be weak and floppy.Definition • "Cerebral palsy" is a general term for a group of disorders that appear during the first few years of life and affect a child's ability to coordinate body movements. However.000 births. getting the right therapy for your child can make a big difference . cerebral palsy occurs in about two to four out of every 1. In Europe and the United States.

CASE COMPONENTS : NAME: rifal ali albishi AGE: 4 years old sex : female nationality : Saudi Diagnosis : CPMR . Date Admitted :20-1-1432 Time : 15:00 h • . ventilator dependent . near miss sids .

Temp 36. If a that hand on the eye responds The leg is supported by pillow between legs Stiffer right arm or legs . O2 98% He breathing by dependent ventilator . Bb 103 – 50 mmhg . . RR 18 cycle/mint . puls 98 b/min .9 .BACKGROUND IN FORMATION Subjective : • Diarrhea Vomiting Objective : • Vital sign.

atropine was given . After 3-4 minutes patients picked with resumed HR and attached to mechanical ventilator . ambu bagging picked up rapidly transferred to close observation . admitted to our pedia ward for investigations and observation . seen immediately by on-call team when she found to be cyanosis . Active resuscitation was done with intubation . . after feeding baby was flaccid . kept NPO . shifted to PICU . cyanosis and not breathing . apnea and severely bradycardia . resuscitated by o2 . breast feeding .active .HEALTH HISTORY: 6 months old . all her investigations came normal (CBC . chest x-ray ).well hydrated .baby presented 2 days ago to our ER with history of twice diarrhea with blood streaks at last one . she was afebrile . 24 hours later mother notice that baby is flaccid. adrenaline . 24 hours after admission . UE .

dry skin color: pink HEAD. NECK : Exterior abnormal / Difficulty moving the neck EYE : pupils right / size 2 reaction normal left /size 2 reaction normal • EAR : Hearing impairment MOUTH: Problem in the growth of teeth in the upper 2 . ABDOMEN • dry skin noted / Sound soft . Lower 4 Secretions from the mouth continuous . absent MUSCULOSKELETAL : unable to respond unable to walk Muscle stiffness • Muscle weakness • . stuporous Activity : quit . crying • SKIN • Poor hygiene .PHYSICAL ASSESSMENT • GENERAL APPEARANCE: conscious.

. looking for characteristic • symptoms.DIAGNOSTIC PROCEDURE : A definitive test for cerebral palsy -. Certain lab tests may help rule out various progressive biochemical disorders that involve the motor system. They also may use computed tomography (CT) scans or magnetic resonance imaging (MRI) scans to look for abnormalities in the infant's brain.does not exist at this time.or CP -. and considering the child's medical history. such as Tay-Sachs disease. Doctors diagnose CP by testing the infant's motor skills. The diagnosis is • based on a child's medical history and a physical exam.

phenobarbitonc 30 mg NGT BID • I Nexium 10 mg • I bacloth 5mg • Sup.MEDICATION : I. kepra 60 mg • Badoten 10 mg not PRN • Sup paracetamol 10 mg not PEN • .

• . many • patients can enjoy near-normal lives if their neurological problems are properly managed. • Cerebral palsy cannot be cured. and therapies that can help your loved one with cerebral palsy. There is no standard therapy that works for all patients. Approaches that can be incorporated in this plan include: • Drugs to control seizures and muscle spasms • Special braces to compensate for muscle imbalance • Surgery • Mechanical aids to help overcome impairments • Counseling for emotional and psychological needs • Physical. Instead. speech. treatments.MANAGEMENT: Strategies. occupational. the doctor must work with a team of health care professionals to identify your loved one’s unique needs and create an individual treatment plan to address them. but treatment can often improve a person’s capabilities. In fact. and/or behavioral therapy.

improving a spastic quadriplegic’s mobility to enable them to walk) is controversial .g. there is clearly no doubt about the role of physiotherapy in maintaining the current function of the child and reducing the incidence and severity of further complications like joint contractures. . improving the child's functional • outcome and managing the associated problems.Management is aimed at minimising the progressive deformity. Physical rehabilitation • Physiotherapy • Physiotherapy is the mainstay of treat-ment for the majority of children with CP.g. improving trunk control to improve a child’s walking ability. The role of • physiotherapy in improving the outcome (e. It is oriented towards activities of daily living by • improving important components of movement.e. However. deformities and dis-locations. 4 • Physiotherapy is not just ‘stretching exercises’. The success of medical and surgical interventions for CP is also highly dependent on rehabilitative exercises to optimise results.

Windswept position in supine should also be avoided to prevent scoliosis and dislocated hip . This will also bring the hands to the midline to play with atopy . Encourage the caregiver to place the child on its side. lying with a pillow between the legs. . if only for transfer from bed to chair. Prone lying over a longitudinal pillow with weight bearing on the forearms should alternate with side lying .Severe spastic quadriplegia • Supine lying should be avoided if possible as this reinforces the abnormal extended • position. Never lose the feet. with the child star-ing at the ceiling. Always teach a caregiver to maintain 90 degrees of ankle dorsiflexion so that even a severely affected child can be placed in the standing position.

• Improve the physical mobility examine the movement of the joints and muscle tone. • • provide a comfortable position and provide support with pillows. • the provision of anti-seizure in the event of a seizure. • • • • provide adequate nutrition . • Improve the nutritional status needs examine the diet of children. • . lots of protein. • ensure that ancillary equipment or dressing appropriately and fixed. examine the pattern of breathing • • examine the area that is attached ancillary equipment.NURSING INTERVENTIONS do suction. • provide an upright position or semi-sitting while eating and drinking. minerals and vitamins. • do the massage in a depressed area. use a skin lotion to prevent dry skin. • • • do repositioning every 2 hours. do immediately when there is suction secretions. do physical therapy. Weigh weight every day.

• Special education for cerebral palsy patients can consist of many different programs. social workers. and physicians can assist families by providing information and education. occupational and physical therapists. . occupational therapy. psychologists. assistive technology. as well as medical intervention. speech-language pathologists. Special education for cerebral palsy patients includes early intervention programs (EIPs) that are family-centered in which professionals and families work together with the child in specific activities. These programs can include speech and language therapy.HEALTH EDUCATION : • Early identification of cerebral palsy can lessen developmental problems by placing a child in a special education for cerebral palsy patients program sooner. Educators. physical therapy.

Thank you • .