Question

Discuss the pathophysiology of in great detail cerebral palsy.

Review the goals of nursing care for the child with cerebral palsy and the family.

What would you teach the family about this disease?

Answer 1

CEREBRAL PALSY

Cerebral Palsy (CP) is a non-progressive neuro motor disorder of cerebral origin ranging from minor incapacitation to total handicap.Most of the cases have multiple neurological deficits and variable mental handicap. The term does not include progressive,degenerative or metabolic disorders of nervous system. It is difficult to estimate the precise magnitude of the problem since mild cases are usually missed.

Patho physiology

Factors can be

a) Prenatal b) During delivery c) Postnatal

Cerebral Malformations,perinatal hypoxia,birth trauma,chorioamnionitis,prothrombotic factors,acid base balance,indirect hyperbilirubinemia,metabolic disturbances and acquired or inherited infections may operate. Prematurity is an important risk factor.  

Cerebral Palsy is classified on basis of topographic distribution,neurologic findings and etiology

Prevention

Prevention of maternal infections,fetal or perinatal insults,good maternal and neonatal care reduces prevalence.Early diagnosis and prompt adequate management plans can reduce the residual neurological and psychosocial emotional handicaps for the child and his family.

Goals of Nursing Care and Parent Education about CP

The plan should be holistic, involve the family and be directed to severity,type of neurological deficits and associated problems. stress on improving posture, reducing tone,preventing contractures and early stimulation are necessary.Identification of associated deficits is important in appropriate physiotherapy and occupational therapy.

Occupational Therapy : The beginning is made with simple movements of self help in feeding and dressing with progressive development of more activities like typing.

Educational : The defects of vision, perception,speech and learning are managed by adequate special education experiences.

Orthopedic support : Tendon, muscle and bony surgeries may be required.

Social : The family should be given social and emotional support to help to live with the child's handicap

Rehabilitation and vocational guidance : Parents should help the child to adjust in the society and if possible to become independent by proper vocational guidance and rehabilitation. Severe handicapped child need to be institutionalized.