Head Injuries

Question 1

if the nurse is not sure what type of injury the patient has, how should they treat that patinet?

Answer 1

assume C spine injury until it is ruled out to keep the airway patient

Question 2

what are clinical manifestations of a skull fracture?

Answer 2

1. Battle’s sign
2. Raccoon eyes
3. cerebrospinal fluid draining from the nose and ear
4. halo’s sign
5. decreased LOC
6. Cheyne-stokes
7. abnormal posturing (decorticate vs decerebrate)

Question 3

What are priority interventions to treat a skull fracture?

Answer 3

1. get initial GCS
2. respiratory status
3. do not place an NG tube in a patient with a basilar skull/facial fracture
4. PERRLA
5. craniotomy

Question 4

what are the first signs that patient has a head injury?

Answer 4

restlessness and changes in LOC are the first signs that a patient has had a stroke

Question 5

what is a craniotomy?

Answer 5

remove bone flap (piece of skull) which allows access to the problem

Question 6

what medications can be given for a head injury patient?

Answer 6

mannitol and steroids can be given every 6 hours for 24-72 hours

Question 7

how should patient lay if they have had a supratentorial surgery?

Answer 7

HOB at 30 degrees

Question 8

how should the patient lay if they have had a infratentorial surgery?

Answer 8

keep patient flat and on either side for 24-48 hours to prevent pressure on the neck incision site

Question 9

what are complications of head injuries?

Answer 9

brain herniation and intracranial hemorrhage/hematoma