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Nursing IV > Head Injury (Gas #14) > Flashcards

Head Injury (Gas #14) Flashcards

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1
Q

Concussion

A

momentary interruption of brain function with or without LOC

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2
Q

s/s of a concussion

A

Photophobia (sensitivity to light), Amnesia, HA, N/V, blurry vision

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3
Q

Discharge planning for a concussion

A

once home, monitor for 24 hrs, wake them up q 2 hrs to monitor mental status, competent caretaker

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4
Q

How long does kid have to wait until he/she can play sport again after Sports related concussion

A

1 week WITH medical clearance

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5
Q

Second Impact Syndrome

A

rapid swelling after injury

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6
Q

Mild severity of concussion

A

transient loss or altered state of consciousness

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7
Q

Moderate severity of concussion

A

loss of consciousness more than 30 minutes

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8
Q

Severe severity of concussion

A

loss of consciousness lasting longer than 2 hours

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9
Q

Very severe severity of concussion

A

loss of consciousness lasting longer than seven days

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10
Q

<14 years of age when will deficits from a concussion resolve?

A

within 3 months; severe deficits within 5 years

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11
Q

Mild head injury Glascow Coma rating

A

13-15

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12
Q

Moderate head injury Glascow Coma rating

A

9-12

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13
Q

Severe head injury Glascow Coma rating

A

8 or less

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14
Q

Glascow Coma Scale

A

rating on eye opening, verbal response, best motor response; greater the # the better

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15
Q

FOUR scale stands for?

A

Full Outline of Unresponsiveness score

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16
Q

FOUR scale

A

motor and eye opening responses (pupil rxns, respiratory pattern

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17
Q

Balance Error Scoring

A

Can be used on the side-line to determine sports related head injuries; determines ability to play, checks for balance problems

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18
Q

Immediate head injury treatment

A

ABC’s, control bleeding-surgery intervention, Monitoring & controlling intracranial pressure, treat other injuries

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19
Q

Primary Injury

A

inital damage to the brain resulting from a traumatic event ex. contusions, lacerations, torn vessels

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20
Q

Secondary Injury

A

hrs & days after the initial injury. due to lack of 02 & nutrients to cells. Due to cerebral edema, ischemia, seizures, infection, hyperthermia, hypovolemia & hypoxia

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21
Q

Contusions/bleeds

A

intracranial hemorrhage; bruise on brain

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22
Q

How to get a contusion/bleed

A

direct trauma, shearing forces on arteries/veins,

23
Q

what determines s/s & time when symptoms occur with a contusion/bleed

A

site & rate of bleeding determines s/s & time when symptoms occur

24
Q

Epidural Intracranial bleed

A

bleed between dura & skull (burr holes are commonly used with this)

25
Q

Subdural intracranial bleed

A

between dura & arachnoid mater (brain); may be slow or fast

26
Q

Intracerebral intracranial bleed

A

in actual brain tissue ex. bullets or stab injury

27
Q

Burr holes are commonly used with which intracranial bleed?

A

Epidural and large acute subdural hematomas

28
Q

4 things you assess with Intracranial Bleed

A

1.)altered LOC 2.) changes in sensory or motor function 3.) pupil change 4.) vs changes

29
Q

Acceleration injury

A

The head is struck by a moving object

30
Q

Deceleration injury

A

when the head hits a stationary object

31
Q

Acceleration-deceleration (coup-countercoup phenomenon)

A

occurs when the head hits an object & the brain “rebounds” within the skull

32
Q

Penetrating Head injury

A

open brain injury; broken bones-youll see gray matter

33
Q

Closed head concussion (blunt)

A

a momentary interruption of brain function with or without loss of consciousness due to the blow to the head or a acceleration-deceleration injury

34
Q

Intracranial hemorrhage examples

A

Epidural, subdural, Intracerebral

35
Q

Skull fractures are classified as

A

open (dura is torn); closed (dura isnt torn) & 1)Liner 2)Comminuted/Depressed 3)Basilar

36
Q

Linear (Simple) Fractures, is dura intact? what can cause this?

A

most common, dura usually intact, subdural or epidural hematoma frequently underly the fracture

37
Q

Communited fractures

A

the bone is crushed into small fragmented pieces

38
Q

Depressed fractures

A

there is an inward depression of bone fragments

39
Q

with Communited/Depressed fractures is dura intact? what may be in brain tissue?

A

dura may or may not be intact, bone fragments may penetrate into the brain tissue

40
Q

Where do basilar fractures occur?

A

usually at the base of the skull, may involve the frontal sinus or temporal bone

41
Q

Manifestations of CSF leakage with Basilar fractures include

A

Rhinorrhea or otorrhea (test for glucose), “Halo” sign

42
Q

“Halo sign with basilar fractures

A

observe for blood tinged fluid, CSF dries in concentric rings on gauze or tissues

43
Q

Basilar fractures

A

if dura is disrupted, CSF may leak through tear; “Halo” & Battles sign may appear

44
Q

Battles sign with basilar fractures

A

seen several days after basilar fracture. there may be bloody drainage from ear right after fracture occured

45
Q

Craniotomy

A

part of skull is removed in order to evacuate chronic subdural hematomas

46
Q

Cushings response

A

when cerebral blood flow decreases significantly when brain is ischemic, it triggers an increase in arterial pressure to overcome the ICP

47
Q

Cushings Triad

A

brain trying to stabilize and fails; bradycardia, HTN, bradypnea

48
Q

3 s/s of cushings response

A

1)increase in systolic pressure 2)increase widing pulse pressure (S&D #s getting farther away) 3)bradycardia, bradyonea

49
Q

Brain stem function

A

automatic functions- heart rate,, breathing, swallowing, motor & sensory pathways

50
Q

Brain Stem consists of?

A

Mid-brain, Pons, Medulla oblongata

51
Q

Decorticate posturing & location

A

abnormal flexion of upper extremities; indicates damage to upper midbrain

52
Q

Decerebrate posturing & location

A

extreme extension of upper & lower extremities & indicates severe damage to brain @ lower midbrain & upper pons

53
Q

Locked in syndrome

A

a lesion affecting the pons or mid brain that causes tetraplegia & inability to speak

Nursing IV (20 decks)

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