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American Women's Club of Hamburg

The Nurse Practitioner is In: Jan/Feb 2010

Currents will be offering a new column for AWC members. I am a certified Nurse Practitioner and will gladly answer any health / illness questions you have. You may submit them to me via email.

You may be wondering what a Nurse Practitioner (NP) is. An NP is a registered nurse who has completed specific advanced nursing education (generally a master’s degree or a doctoral degree) and training in the diagnosis and management of common as well as complex medical conditions. NPs provide a broad range of health care services. NPs, along with other advanced practice nurses, function within the scope of their state’s nurse practice act and have varying levels of physician collaboration.

In some states, NPs function independently of physicians. NPs treat both acute and chronic conditions through comprehensive history taking, physical exams, diagnostic work-ups, and ordering therapies within their scope of practice. NPs also incorporate health education and disease management into their practice. There are many specialties among NPs and we practice in various settings from acute care (e.g. hospitals & emergency departments), to clinics and long-term care.

Dear Nurse Beth:

How do I know if my non-verbal toddler has a concussion after a fall and hitting their head?

Dear Reader,
First of all, if you witness the fall, watch to see how they behave immediately afterward. If they seem stunned and sleepy, they could have suffered a concussion. If you did not witness the fall, then the most important thing to monitor after a fall with a head injury is any change in the toddler’s behavior. If there is a significant change in their behavior, it is cause for concern. Keep a close eye on your toddler’s head following their injury. If you identify bruising or swelling, call your health care provider and report what happened and the location and description of the bruising or swelling. Be suspicious if your toddler becomes less energetic or is generally listless after bumping their head. Call your doctor if your toddler becomes very moody or irritable. If the toddler is continually crying and you do not perceive this as due to normal fatigue or hunger, this could be a sign of a concussion. Monitor for changes in eating or sleeping habits, this can also signal a concussion-related injury.

Take your toddler to see a doctor if you perceive any imbalances in their gait or while they crawl. Being off balance can be a significant sign of a concussion. Watch your toddler at playtime. An unexplainable lack of interest in favorite games or toys should be reported to your health care provider. Err on the side of caution when it comes to toddlers and head injuries. Their symptoms are much more difficult to detect and you don’t want to run the risk of long-term neurological damage that could have be prevented. Physical signs of neurological issues are pupil size - they should be equal in size (only rarely do some people have unequal pupils and no problems) and the pupils should react to light. This means they contract down in size quickly and equally when light is shone into their eyes. Another physical symptom could be repeated, projectile vomiting. It goes without saying that if your child is unconscious, call 112!!

There are some things you can do to try to reduce mishaps and injuries: baby-proof your home. Crawl on the floor at their level and look for hazards which, of course, you should then remove. Look for sharp edges on furniture and add padding. Anything that is small enough for them to put in their mouth can be a choking hazard. Place gates at the top and bottom of all staircases. There are also door safety latches for cupboards and electrical plug safety caps. You can also use gates in doorways to prevent toddlers from going in to rooms that haven’t been baby-proofed.

Beth M, CNP

originally published in Currents Jan/Feb 2010

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