Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NSG 430 - Critical Care > T9: Head Injury TBI (Traumatic Brain Injury) > Flashcards

T9: Head Injury TBI (Traumatic Brain Injury) Flashcards

1
Q

Traumatic Brain Injury

A

a blow to the head or a penetrating head injury that damages the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

majority of deaths after a head injury occur immediately after the injury, either from

A

*the direct head trauma or from massive hemorrhage and shock.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Deaths occurring within a few hours of the trauma are caused by

A

*progressive worsening of the brain injury or internal bleeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Deaths occurring 3 weeks or more after the injury result from

A

multisystem failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Linear fracture occurs when

A

*there is a break in continuity of bone without alteration of relationship of parts. It is associated with low-velocity injuries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

depressed skull fracture

A

inward indentation of skull and is associated with a powerful blow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

simple linear or depressed skull fracture

A

*without fragmentation or communicating lacerations. It is caused by low to moderate impact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

comminuted fracture occurs

A

*occurs when there are multiple linear fractures with fragmentation of bone into many pieces. It is associated with direct, high-momentum impact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

r potential complications of skull fractures

A

*intracranial infections, hematoma, and meningeal and brain tissue damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The location of the fracture determines

A

*the clinical manifestations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Basilar Skull Fracture

A

a specialized type of linear fracture that occurs when the fracture involves the base of the skull. Manifestations can evolve over the course of several hours, vary with the location and severity of fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

clinical manifestations of basilar skull fracture

A

cranial nerve deficits, Battle’s sign (postauricular ecchymosis), and periorbital ecchymosis (raccoon eyes).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Brain injuries are categorized as

A

diffuse (generalized) or focal (localized).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

diffuse injury

A

*damage to the brain cannot be localized to one particular area of the brain.

(e.g., concussion, diffuse axonal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

focal injury

A

damage can be localized to a specific area of the brain.

(e.g., contusion, hematoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Brain injury can be classified as

A

minor: GCS 13 to 15
moderate: GCS 9 to 12
severe: (GCS 3 to 8).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

signs of concussion

A

*brief disruption in LOC, amnesia regarding the event (retrograde amnesia), and headache. The manifestations are generally of short duration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Postconcussion syndrome can occur

A

anywhere from 2 weeks to 2 months after the injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Postconcussion syndrome s/s

A

*Persistent headache
*Lethargy
*Personality and behavior changes
*Shortened attention span, decreased short-term memory
*Changes in intellectual ability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Diffuse Axonal Injury

A

*widespread axonal damage occurring after a mild, moderate, or severe TBI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

s/s of diffuse axonal injury

A

*varied but may include a decreased LOC, increased ICP, decortication or decerebration, and global cerebral edema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lacerations

A

involve actual tearing of the brain tissue and often occur in association with depressed and open fractures and penetrating injuries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

contusion

A

*bruising of the brain tissue within a focal area.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what do we ask a patient with a contusion?

A

ARE YOU ON ANY ANITCOAGULANTS??? BECAUSE THEY HAVE A BRUISING WHICH IS BLEEDING!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Coup-Contrecoup Injury

A

Dual impacting of the brain into the skull; coup injury occurs at the point of impact; contrecoup injury occurs on the opposite side of impact, as the brain rebounds

26
Q

with contusion what are we monitoring for

A

*Monitor for seizures
*Potential for increased hemorrhage if on anticoagulants

27
Q

Epidural and Subdural Hematoma intervention

A

Subdural Hematoma intervention
Evacuate these (suck them up) and try to decrease ICP in surgery

28
Q

epidural hematoma

A

*results from bleeding between the dura and inner surface of the skull. neurological emergency

29
Q

Classic signs of an epidural hematoma

A

an initial period of unconsciousness at the scene, with a brief lucid interval followed by a decrease in LOC.
*Headache, nausea, vomiting
*Focal findings

30
Q

intervention for epidural hematoma

A

Rapid surgical intervention to evacuate the hematoma and prevent cerebral herniation, along with medical management for increasing ICP

31
Q

subdural hematoma

A

occurs from bleeding between the dura mater and arachnoid layer of the meninges

32
Q

*Acute Subdural Hematoma

A

*Within 24 to 48 hours of injury
*Symptoms related to increased ICP
*↓ LOC, headache
*Ipsilateral pupil dilated and fixed if severe

33
Q

*Subacute Subdural Hematoma

A

*Within 2 to 14 days of the injury
*May appear to enlarge over time

34
Q

*Chronic Subdural Hematoma

A

*Weeks or months after injury
*More common in older adults
*Presents as focal symptoms
*↑ Risk for misdiagnosis
*ETOH-atrophy and falling high percentage
*Subtle symptoms-mimic TIA,dementia somnolence,confusion,lethargy,memory

35
Q

Delay in diagnosis of a subdural hematoma in the older adult can be attributed to

A

symptoms that mimic other health problems in persons of this age group, such as somnolence, confusion, lethargy, and memory loss.

36
Q

Intracerebral Hematoma

A

*occurs from bleeding within the brain tissue and occurs in approximately 16% of head injuries.

37
Q

Diagnostic Studies

A

*CT scan (Best diagnostic test to determine craniocerebral trauma)
*MRI, PET, evoked potential studies
*Transcranial Doppler studies
*Cervical spine x-ray
*Glasgow Coma Scale (GCS)

38
Q

head injury treatment principles

A

*Prevent secondary injury
*Timely diagnosis
*Surgery if necessary

39
Q

For the patient with concussion and contusion interventions include

A

observation and management of increased ICP are the primary management strategies.

40
Q

intervention for depressed skull fracture

A

*a craniotomy is necessary to elevate the depressed bone and remove the free fragments. If large amounts of bone are destroyed, the bone may be removed (craniectomy), and a cranioplasty will be needed at a later time.

41
Q

craniotomy

A

incision of the skull performed to visualize and allow control of the bleeding vessels

42
Q

burr-hole

A

used in an extreme emergency for a more rapid decompression, followed by a craniotomy.

43
Q

emergent treatment for patients with head injury

A

*Stabilize cervical spine. REMAIN HEAD IN NEUTRAL POSTION
*Administer O2 via non-rebreather mask.
*Establish IV access with two large-bore catheters to infuse normal saline or lactated Ringer’s solution.
*Intubate if GCS <8.
*Control external bleeding with sterile pressure dressing.
*Remove patient’s clothing.

44
Q

maintain patients warmth by

A

warmth using blankets, warm IV fluids, overhead warming lights, warm humidified O2

45
Q

what GCS indicates intubation

A

GCS <8

46
Q

objective data for head injury

A

*Altered mental status
*Lacerations, contusions, abrasions
*Hematoma
*Battle’s sign
*Periorbital edema and ecchymosis
*Otorrhea
*Exposed brain

47
Q

otorrhea

A

CSF leaking from the ear

48
Q

rhinorrhea

A

CSF leakage from the nose

49
Q

Cushing’s triad indicates

A

impending herniation

50
Q

cushings triad

A

systolic hypertension with widening pulse pressure, bradycardia with full and bounding pulse, irregular respirations

51
Q

GI/GU objective data for head injury

A

-Vomiting, projectile vomiting, bowel incontinence
-Bladder incontinence

52
Q

neuro objective data for head injury

A

Altered level of consciousness, seizure activity, pupil dysfunction, cranial nerve deficit(s)

53
Q

muscoloskeletal system objective data for head injury

A

Motor deficit/impairment, weakness, palmar drift, paralysis, spasticity, decorticate or decerebrate posturing, muscular rigidity/increased tone, flaccidity, ataxia

54
Q

overal all goals for head injury

A

*Cerebral oxygenation and perfusion
*Normothermic
*Control pain and discomfort
*Free of infection
*Adequate nutrition
*Maximal cognitive, motor, and sensory function

55
Q

*Hyperthermia-hypothalamus damage goals

A

*Goal 36°to 37° C
*Prevent shivering

56
Q

Eye problems may include

A

corneal reflex, periorbital ecchymosis and edema, and diplopia.

57
Q

interventions or eye problems

A

-Loss of the corneal reflex may necessitate administering lubricating eye drops or taping the eyes shut to prevent abrasion.
-Periorbital ecchymosis and edema decrease with time, but cold and, later, warm compresses provide comfort and hasten the process.
-Diplopia can be relieved by use of an eye patch

58
Q

*Measures for patients leaking CSF

A

*Head of bed elevated
*Loose collection pad under nose/over ear
*No sneezing or blowing nose
*No NG tube
*No nasotracheal suctioning

59
Q

*Acute rehabilitation

A

*Motor and sensory deficits
*Communication issues
*Memory and intellectual functioning
*Nutrition
*Bowel and bladder management

60
Q

what may occur in patients with nonpenetrating head injury

A

Seizure disorders so Antiseizure drugs may be used prophylactically to manage posttraumatic seizure activity

61
Q

what is often the most incapacitating problem after head injury

A

*Mental and emotional difficulties-personality changes with progressive coma

62
Q

*Health Promotion -Secondary Prevention

A

*Prevent car and motorcycle accidents
*Wear safety helmets
*Use seat belts and child car seats
*Home safety to prevent falls

NSG 430 - Critical Care (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions