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NCLEX - HURST REVIEW (Neurology) > Neurological Alterations (Traumatic Brian Injury - TBI) > Flashcards

Neurological Alterations (Traumatic Brian Injury - TBI) Flashcards

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1
Q

What are TBI’s defined as ?

A

Any injury that results in damage to the bran

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2
Q

TBI’s can be either _______ or ________ ?

A

Open or Closed

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3
Q

How is a Closed TBI defined ?

A

The brain is injured, But the skull is not broken, fractured, or penetrated.

The Dura is not Torn

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4
Q

How is a Open TBI defined ?

A

Brain injury, where the skull IS broken, fractured, or penetrated.

The Dura IS torn in a penetrating injury

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5
Q

What is important to note with Open TBI’s ?

A

The Location of the skull fracture

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6
Q

____________ skull fractures are the most serious ?

A

Basillar

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7
Q

With Basillar skull fractures, where would you see bleeding ?

A

EENT

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8
Q

______________ is a sign of a skull fracture ?

A

Battle’s sign

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9
Q

What is a Battle’s sign ?

A

Bruising over the mastoid bone (bone behind the ear)

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10
Q

What are other signs of Open TBI’s ?

A
  • Raccoon eyes (peri-orbital bruising)

- Cerebrospinal rhinorrhea

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11
Q

What is Cerebrospinal-rhinorrhea ?

What do we want it to do ?

A

Leaking spinal fluid from your nose

Want it to flow freely until it heals itself

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12
Q

How do you tell CSF from other types of drainage ?

A

CSF will be positive for glucose and the halo test

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13
Q

What is the Halo test ?

A

A ring or halo around a blood spot on sheets

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14
Q

What types of skull fractures usually do not require surgery ?

A

Non-depressed

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15
Q

Depressed skull fractures usually require what ?

A

Surgery

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16
Q

What are two types of Focal injuries that are seen with TBI’s ?

A
  1. ) Contusions

2. )Hematomas

17
Q

What are Contusions usually seen with ?

A

Seen with Blunt trauma or acceleration-deceleration injuries like whiplash

18
Q

With Contusion injuries, the brain is ________ and ___________ ?

A

Bruised and damaged

19
Q

A small hematoma that develops rapidly may be what ?

A

Fatal

20
Q

A massive hematoma that develops slowly may do what ?

A

May allow the client to adapt

21
Q

A fast and acute bleed will cause what ?

A

Instant ICP

22
Q

What is the Pathophysiology of an Epidural Hematoma ?

A

A rupture or laceration of the middle meningeal artery

(fast bleeder under high pressure)

23
Q

What is the progression of symptoms in a client with an Epidural Hematoma ?

A

Injury –> loss of consciousness –>Recovery period –> Bleeding into their head (increased ICP) –> Can’t compensate anymore –> Neuro changes –> Coma

24
Q

What are the Tx’s for an Epidural Hematoma ?

A
  • Burr holes (to remove the clot, stop the bleeding, and control the ICP)
25
Q

What types of questions do you want to ask to someone with an Epidural Hematoma ?

A
  • Did they pass out and stay out ?
  • Did they pass out, wake up, and pass out again ?
  • Did they just see stars ?
26
Q

An Epidural Hematoma is what ?

A

An Emergency!

27
Q

What is the Pathophysiology of a Subdural Hematoma ?

A

A collection of blood between the dura and the brain

28
Q

Subdural Hematomas are usually what types of bleed ?

A

Venous bleeds (Slower than an arterial)

29
Q

Subdural Hematoma can be what ?

A
  • acute (fast)
  • Subacute (medium)
  • Chronic (slow)
30
Q

What are the Tx’s for a Subdural Hematoma ?

A
  • Acute or chronic = immediate craniotomy to remove clot and control the ICP
31
Q

Chronic Subdural Hematomas do what ?

A

Immitates other conditions (ex: appear drunk, stroke, etc)

  - Bleeding and compensating
  - Neuro changes = compensation maxed out
32
Q

What are two types of TBI’s ?

A

a. ) Foacal injuries

b. ) Diffuse Brian injuries

33
Q

What is a type a Diffuse Brian Injury ?

A

Concussion

34
Q

What is a concussion ?

A

Temporary loss of neurologic function with complete recovery

35
Q

True or false:

With a concussion you will have a short period of unconsciousness or they may just get dizzy and see spots ?

A

True

36
Q

What signs do you want to teach the caregiver that require them to bring the client back to the ED ?

A
  • *Difficulty awakening/speaking
  • Confusion
  • Severe headache
  • vomiting
  • pulse changes
  • Unequal pupils
  • one-sided weakness

(signs that the ICP is going up)

NCLEX - HURST REVIEW (Neurology) (7 decks)

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