409 Final 9 TBI

Question 1

A direct injury verse indirect

Answer 1

direct means a hit to the head, indirect means hit somewhere else but there’s a rebound affect where the brain get shook

Question 2

The most common areas for injury are

Answer 2

frontal and temporal lobes

Question 3

Besides direct and indirect, you can categorize brain injury as

Answer 3

primary or secondary

Question 4

Primary brain injury happens

Answer 4

at the time the trauma happened, whereas secondary develops later

Question 5

Moderate TBI: you could lose

Answer 5

consciousness for 6 hours

Question 6

Moderate TBI: you could have s___ problems

Answer 6

systemic problems

Question 7

Moderate TBI: you could have difficulty with w___/learning

Answer 7

working/learning

Question 8

Sever TBI: unconscious for

Answer 8

more than 6 hours

Question 9

A basilar skull fracture results in

Answer 9

CSF leaking from nose and ears

Question 10

A basilar skull fracture has potential for

Answer 10

hemorrhage

Question 11

Concussion is when

Answer 11

the brain shakes around in the head

Question 12

A diffuse axonal injury to the brain means

Answer 12

the damage is widespread

Question 13

A diffuse axonal injury to the brain is usually caused by

Answer 13

car crash

Question 14

As ICP increases, perfusion to the brain decreases because the brain is

Answer 14

pushing away in order to decrease pressure

Question 15

As ICP increases, perfusion to the brain decreases because the brain is pushing away in order to decrease pressure. However, the brain must quickly

Answer 15

“give in” to ICP because it can’t deal with the decreased perfusion.
So it vasodilates, which then continues the ICP

Question 16

If ICP gets really bad, the brain ____, causing severe injury and death

Answer 16

herniates

Question 17

Epidural hematoma means

Answer 17

blood collecting between the dura and the inside of the skull

Question 18

Epidural hematoma: how does it progress

Answer 18

After this kind of injury, the patient will be knocked out within a few min. Then they wake up lucid. It’s an emergency

Question 19

Hydrocephelus means

Answer 19

too much volume in the brain

Question 20

An uncal herniation

Answer 20

is an especially dangerous kind of brain herniation

Question 21

In central herniation, you have

Answer 21

pin point pupils and chennye stokes

Question 22

Signs of increased ICP includes (hyper and hypo)

Answer 22

hypercapnia

hypoxemia

Question 23

Until you have an x ray result, treat the patient as if

Answer 23

they have a spinal injury

Question 24

Loss of feeling, head tilt, and tenderness on the back can indicate

Answer 24

they have a spinal injury

Question 25

The BP of someone with TBI could be

Answer 25

up or down

Question 26

Cushings triad is

Answer 26

a late sign of ICP
HTN
Wide pulse pressure
bradycardia

Question 27

If a TBI patient gets hypotension or tachycardia, it could mean

Answer 27

they’re going into hypovolemic shock

Question 28

One thing that is ALWAYS a sign of ICP

Answer 28

papilledema

Question 29

If you suspect CSF leakage, check for nuchal rigidity, which is

Answer 29

stiff neck (but do NOT check the neck until you get x ray results)

Question 30

If you just had a mild injury, you prob won’t have

Answer 30

long term problems

Question 31

position HOB

Answer 31

30 degrees

Question 32

A barbituate may be needed if

Answer 32

you can’t control ICP by other means

Question 33

A person with mild injury has a headache…

Answer 33

that’s normal for 24 hours, but if it doesn’t get better escalate

Question 34

with a mild head injury, for 48 hours

Answer 34

dont exercise, blow your nose, clean your ears

Question 35

Chest trauma: After a pulmonary contusion, when does respiratory failure develop

Answer 35

over time instead of immediately

Question 36

Rib fracture: there’s a risk that the rib could

Answer 36

puncture the lung

Question 37

An injury to the ___ or ___ rib has an especially bad prognosis

Answer 37

1st or 2nd

Question 38

Management of uncomplicated rib fracture

Answer 38

is easy because it heals spontaneously. You shouldn’t need a splint, just control the pain

Question 39

Flail chest

Answer 39

chest movement is the opposite of what it should be. Moves in when you breath in

Question 40

Flail chest has a high ____ rate

Answer 40

mortality

Question 41

2 common ways to get flail chest

Answer 41

car crash or CPR

Question 42

Flail chest: 2 nursing actions

Answer 42

encourage DB and C

Give humidified O2

Question 43

An open pneumothorax is when

Answer 43

there’s a wound starting from the outside exposing the pleural space

Question 44

A closed pneumothorax example is when

Answer 44

someone with COPD has a spontaneous tear

Question 45

with a pneumothorax Percussion would show

Answer 45

hyperresonnace

Question 46

In a closed pneumothorax there’s no where for the pressure to flow, so it pushes the trachea

Answer 46

away from the affected area

Question 47

Tension pneumothorax involves

Answer 47

the lung collapsing

Question 48

Tension pneumothorax: When the patient breaths in, air gets in the pleural space, but

Answer 48

it doesn’t flow back out when they exhale

Question 49

Tension pneumothorax: the increased pressure in the lungs pushes on the blood vessels which means

Answer 49

there’s less blood flowing to the heart, less CO