impairments: One out of every three children with CP has a mild
intellectual impairment, one-third have moderate to severe impairments, and
the remaining third have age-appropriate cognitive development similar to that
of typically-developing peers. Children who have spastic quadriplegia are most
likely to have more serious cognitive deficits. Under Federal law, developmental
and educational systems have been established to address these cognitive impairments
(see Developmental and Educational Teams section of this
course). Nurses fill many key roles within these systems.
disorders: About half of the children with CP have some form
of seizure disorder. The type and severity of the seizure depends on the part
of the brain involved, and the degree of impairment. For example, mild involvement
of one portion of the brain can cause partial seizures with very specific symptoms.
More severe seizure disorders may involve the entire brain in a prolonged, uncontrolled
burst of electricity that creates a generalized onset tonic-clonic seizure.
These seizures are treated with anticonvulsant medications, vagal nerve stimulators,
and rarely, surgery. Nurses working with these patients can teach parents to
administer seizure medications, on time, with good technique, while watching
for adverse effects of the anticonvulsants.
Children with CP are more likely to develop hydrocephalus, or a blockage in
the flow of cerebrospinal fluid. The blockage may be caused by malformations
within the brain, precipitated by intracranial bleeding, or triggered by meningitis.
Most of the time, the hydrocephalus is readily relieved with a ventriculoperitoneal
shunt, which can be revised as the child grows up. Nurses working with these
children can watch for early signs of shunt failure, including change in level
of consciousness, seizures, and vomiting.