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Head Injury

What are the different type of injuries? scalp lacerations, skull fractures, minor head trauma and major head trauma
Why are scalp lacerations of concern? The scalp is very vascular and a lot of bleeding can occur and can also become infected
What are the different types of skull fractures? linear/depressed, simple, comminunted, complex, open or closed
What complications can arise from a skull fracture? hematoma, intracranial infection and meningeal and brain tissue damage
What does an open skull fracture entail? Requires an ID, and possible dural closure if CFS is leaking
What are the clinical manifestations of a skull fracture? facial paralysis, Battle's sign, periorbital eccymosis (raccoon eyes), conjugated deviation of the gaze, rhinorrhea, ottorrhea (+ CFS gives dura tear), +VE for glucose
What is Battle's sign? mastoid eccymosis (bruising behind the ear)
What is a minor diffuse injury and what are the S/S? concussion, decreased LOC, retrograde amnesia, and HA
How long does post-concussion syndrome last? 2 weeks to 2 months
What are the S/S of post-concussion syndrome? persistent HA, lethargy, sometimes dizziness, personality and behavioral changes, short attention span and short term memory loss
What is another name for a major head trauma? Traumatic Brain Injury (TBI)
Which types are TBIs? contusions and lacerations
What is coup and contre-coup? coup is the blow at the direct impact on the skull and contre-coup is secondary area of damage on the opposite side (against the blow)
What is a contusion? a mass movement of the brain inside the skull
What are the effects of a contusion? minimal bleeding around the site, focal changes, decreased LOC and seizures
What are the S/S of a laceration? hemorrhage, hematoma, seizures, cerebral edema
What are S/S of an intracranial hemorrhage? unconsciousnesses, hemiplegia on contralateral side, dilated pupil on ipsilateral side
Where does a epidural hematoma occur? between dura and inner surface of the skull
Where does subdural hematoma occur? between the dura matter and the arachnoid layer
Where does an intercerbral hematoma occur? within the parenchyma
How can you tell the difference between a arterial and venous epidural hematoma, what is the main difference? arterial=rapid onset of S/S, venous=slower onset
What S/S is specific to an arterial epidural? brief lucid interval
What is a subdural hematoma? Injury to the brain substance and parenchymal vessels, usually a vein
What are the different types of subdural hematomas? acute=within 48 hours, subacute=within 2-14 days, chronic= over weeks or months
What are the S/S of an acute subdural? decreased LOC, HA, ipsilateral pupil dilates and fixed
What are the S/S of a subacute subdural hematoma? failure to regain consciousness
What are the S/S of a chronic subdural? memory loss, somnolence, confusion, lethargy
Where do intracranial hematomas usually occur? frontal and temporal lobes
What are usually the causes of intracranial hematomas? HTN, aneurysms
What are the collaborative management goals? management of IICP, treat cerebral edema and a timely diagnosis
What are the priorities of nursing management? maintain patent airway, 02, asses neuro checks, reduce anxiety, GCS
What do the GCS indicate? Score of 13-15= mild, 9-12=moderate, 3-8=severe
What to do for loss of corneal reflex? lubercating eye drops, tapped shut, apply cold/warm compress to periorbital area for eccymosiss and edema, apply eye patch to reduce diplopia
What effect does hyerthermia have in regards to brain injuries? it increases metabolism and increases cerebral vasodilation and ICP
How to asses and manage rhinorrhea and ottorrhea HOB may be raised to reduce CSF pressure Place a loose collection pad under the nose or over the ear Do not sneeze or blow the nose No nasotracheal suctioning or NG tubes
What precautions should head injury patients be on? seizure, skin if immobile, also bladder and bowl function management
What is euvolemia? The maintenance of proper amount of blood in body
Created by: brebre273