Traumatic Brain injury

Question 1

What is a primary brain injury?

Answer 1

First insult

Question 2

What is a secondary brain injury?

Answer 2

The injury we can prevent

Question 3

List the types of primary/traumatic brain injuries

Answer 3

Contusion

Epidural hematoma

Subdurral hematoma

Traumatic subarachnoid hemorrhage

Diffuse axonial injury

Question 4

What is a diffuse axonal injury?

Answer 4

Primary brain injury where the head gets shaken so much the axons shear

Question 5

Main 3 symptoms of diffuse axonial injury?

Answer 5

Coma - most people have this

Confusion

N/V

Question 6

Main two goals of managing the secondary injury of a traumatic brain injury

Answer 6

Increase oxygen supply to the brain

Decrease metabolic needs

Question 7

Mild GCS score

Answer 7

13-15

Question 8

Moderate GCS score

Answer 8

9-12

Question 9

Severe GCS score

Answer 9

Less than 8

Question 10

What brain injuries are diagnosed with CT

Answer 10

Hematomas

Hemorrhage

Fractures

Cerebral edema

Question 11

Brain injuries that are diagnosed with an MRI

Answer 11

Severe diffuse axonial injuruy

Herniation of brainstem

Aneurysm

Question 12

What is the concern with an aneurysm?

Answer 12

The bulge will hemorrhage and cause a stroke

Question 13

List the traumatic brain injuries again (same as primary)

Answer 13

Contusion

Epidural hematoma

Subdurral hematoma

Traumatic subarachnoid hemorrhage

Diffuse axonial injury

Question 14

What are the main 3 fractures that can occur to the skull?

Answer 14

Linear

Depressed

Basilar

Question 15

Linear fracture description

Answer 15

Hairline fx, no treatment needed

Question 16

Depressed fracture description

Answer 16

Part of the bone is depressed down into the brain. Need to remove with surgery

Question 17

Basilar fracture description

Answer 17

At the base of the neck. Will have CSF leakage from nose and ears.

Battles sign may be present on children at the ears.

Question 18

Priority nursing diagnosis for Traumatic Brain injuries

Answer 18

Respiratory

Volume

Lower O2 demand

Risk for immobility complications

Question 19

How do we address the respiratory care for a traumatic brain injury?

Answer 19

Airway management - make sure its not compromised

Give oxygen - NC

Ventilate or intubate the patient if needed

Question 20

How to address the volume concerns with a traumatic brain injury patient?

Answer 20

Give fluids

Monitor ICP

Monitor CPP & give pressors such as dopamine etc

Question 21

How can we lower the o2 demand for a traumatic brain injury patient?

Answer 21

Sedation

Question 22

What are the risks for the immobility for a traumatic brain injury patient?

Answer 22

Pneumonia (lung sounds)

PE (lung sounds)

DVT (anticoagulation)

Skin integrity (turning)