TBI

Question 1

What is TBI

Answer 1

• Disruption in brain fxn due to trauma
• primary injury can lead to secondary injury that further damages
• hypoxia, ischemia, cerebral edema, hypotension

Question 2

Sx of TBI

Answer 2

• related to ICP
• decreased LOC
  -Cushing triads (systolic HTH, bradycardia, irregular breathing)
• HA
  -pupillary changes
• confusion
• N/v
• seizure
• abnoramal posturing

Question 3

DX

Answer 3

MRI or CT

Question 4

Tx

Answer 4

Drugs: mannitol decrease ICP
- hypertonic saline to draw fluid and decreas swelling
- phenobrabital induces coma decrase metabolic needs
- anticonvulsants
- analgesic

Question 5

What Procedures may be done

Answer 5

-Craneoactomy
- mechanical vent
- ICP monitoring

Question 6

Nursing care

Answer 6

• stabilize cervical spine
• maintain patent airway
• monitor LOC
• decrease ICP ( avoid suctioning, HOB 30 or more, keep head midline, no coughing, no nose blowing

Question 7

Brain herniation

Answer 7

• downward movement of brain tissue due to edema

Question 8

Sx of herniation

Answer 8

• fixed/ dialted puppils
  -LOC
• abnormal respirations
• abnormal posturing

Question 9

Other complications include

Answer 9

• hematoma
• hemorrhage
• epidural hematoma bleeding btwn dura mater and skull
• subdural hematoma -> dura mator or arachnoid
• intra-cerbral hemorhahge
• hydrocephalus
  -SIADH