CH 6 Medical Complications Flashcards
What are possible early and chronic cardiopulmonary issues?
cardiac and respiratory problems 2/2 trauma to chest, complications of trauma or trauma care and damage to areas of brain
May require mech vent, trach
May result in weak cough, dysphagia, impaired gag reflex, dysautonomia
List 6 examples of neurobiologically based complications following brain injury
Changes to reflexes and sensory integration
Spasticity
Hyperrflexia
Contractures
Heterotopic ossification
What are common signs of UTI
changes in cognition/behavior
agitation
decreased level of alertness
What are 4 possible causes of bladder issues?
Less capacity in bladder
SCI
altered bladder sensation
increased urinary urgency or frequency
What can impact gastrointestinal motility?
changes in mobility, tube feeds, fluid intake, meds, etc.
What can promote bowel regularity?
Timed routine
adjusting meds/food, increase fluids
How does brain injury affect metabolic needs?
increases significantly, require at least 40% more calories
Why is nutritional management critical following BI?
helps maintain fx independence, mobility, cardiovascular and endocrine health
What percentage of ppl with TBI had dysphage in the oral/pharyngeal phase?
65% oral
73% pharyngeal
What percent of individuals with severe TBI have dysphagia?
90% early after injury
What are 4 types of endocrine dysfunction following BI
- hypopituitarism
- gonadotropic dysfunction
- growth hormone dysfunction
- metabolic syndrome
What are risk factors for metabolic syndrome?
history of HTN, DM , smoking, obesity, long term use of antipsychotics
What are medical management strategies for metabolic syndrome?
diet and weight loss, decrease saturated fats and cholesterol. increase fiber, monitor sodium, lower stress, quit smoking
List 5 health challenges specific to women with disabilities
- depression
- osteoporosis
- premenstrual mood dysphoria
- dysmenorrhea
- increased risk for cardiovascular disease over time
List 5 measures to prevent skin conditions associated with contracture, spasticity and decreased mobility.
- keep skin clean and dry
- change position every 2 hours
- use specialty cushions
- frequent skin checks/vigilance
- adequate nutrition/hydration
What conditions can contribute to development of pressure sores
- decreased mobility
- dependence on others for ADLs
- incontinence
- shearing
- inadequate pressure relief
When are ppl with BIs particularly susceptible to infection?
open wounds, indwelling devices, immunocompromised/supressed
List 4 common infections with individuals with BI
- meningitis
- respiratory infections
- urosepsis
- cellulitis
How can hypersomnia and insomnia affect ppl with BI?
can exacerbate TBI symptoms including cognitive and mood problems, pain and irritability
How are OSA and central sleep apnea different
obstructive=upper airway blocks breathing, resulting in HTN and heart problems
central=changes in feedback loop from lung to brain associated with decreased oxygen in blood
List the 3 most common neurologic complications of brain injury
- seizures
- chronic pain
- headache
After TBI, people are ___ times more likely to die of a seizure disorder compared to the general population
35 times
Is an immediate post-traumatic convulsion considered or treated as epilepsy? Why?
No, believed to be more like syncope possible 2/2 loss of cerebral function and loss of cortical inhibition. Not fully understood but may be reflexive brainstem activation
When is a seizure a health emergency?
First seizure or has difficulty breathing or waking up after
