NEURO CASE STUDY
Y.W. is a 23-year-old male student from Thailand studying electrical engineering at the university. He was ejected from a moving vehicle, which was traveling at 70 mph. His injuries include a severe closed head injury with an occipital hematoma, bilateral wrist fractures, and a right pneumothorax.
1. Define the term primary head injury and describe the mechanism of injury for the student in this case study (how it occurs). (4 points)
A primary injury is the initial damage to the brain as a result of an accident (Hinkle & Cheever, 2014). The primary injury in this case occurred as a result of acceleration, deceleration and then impact. The acceleration, deceleration and impact resulted in a closed head injury, damaging the brain tissue (Hinkle & Cheever, 2014).
2. …show more content…
Identify four late signs and symptoms of increased ICP. (2 points)
1) Decreasing level of consciousness leading to a comatose state (Hinkle & Cheever, 2014).
2) Decreased pulse rate, decreased respiratory rate, increased blood pressure and increased temperature (Hinkle & Cheever, 2014).
3) Cheyne-Stokes respirations (Hinkle & Cheever, 2014).
4) Loss of brain stem reflexes (Hinkle & Cheever, 2014).
8. List two medication classifications that the ICU nurse could use to control or reduce increased ICP. For each medication, describe the primary action of each, identify major and frequent side effects that the nurse needs to monitor the patient for. (8 points – [4 points for each medication])
• Osmotic diuretics (mannitol) o Primary action: increases osmotic pressure of the glomerular filtrate, inhibiting reabsorption of water and electrolytes (Vallerand, Sanoski, & Deglin, 2015). Osmotic diuretics dehydrate brain tissue and reduce cerebral edema (Hinkle & Cheever, 2014). o Side effects: pulmonary edema, heart failure, tachycardia, nausea, vomiting, confusion, headache, blurred vision (Vallerand, Sanoski, & Deglin, 2015).
• Inotropic agents (dobutamine or
Y.W. is a 23-year-old male student from Thailand studying electrical engineering at the university. He was ejected from a moving vehicle, which was traveling at 70 mph. His injuries include a severe closed head injury with an occipital hematoma, bilateral wrist fractures, and a right pneumothorax.
1. Define the term primary head injury and describe the mechanism of injury for the student in this case study (how it occurs). (4 points)
A primary injury is the initial damage to the brain as a result of an accident (Hinkle & Cheever, 2014). The primary injury in this case occurred as a result of acceleration, deceleration and then impact. The acceleration, deceleration and impact resulted in a closed head injury, damaging the brain tissue (Hinkle & Cheever, 2014).
2. …show more content…
Identify four late signs and symptoms of increased ICP. (2 points)
1) Decreasing level of consciousness leading to a comatose state (Hinkle & Cheever, 2014).
2) Decreased pulse rate, decreased respiratory rate, increased blood pressure and increased temperature (Hinkle & Cheever, 2014).
3) Cheyne-Stokes respirations (Hinkle & Cheever, 2014).
4) Loss of brain stem reflexes (Hinkle & Cheever, 2014).
8. List two medication classifications that the ICU nurse could use to control or reduce increased ICP. For each medication, describe the primary action of each, identify major and frequent side effects that the nurse needs to monitor the patient for. (8 points – [4 points for each medication])
• Osmotic diuretics (mannitol) o Primary action: increases osmotic pressure of the glomerular filtrate, inhibiting reabsorption of water and electrolytes (Vallerand, Sanoski, & Deglin, 2015). Osmotic diuretics dehydrate brain tissue and reduce cerebral edema (Hinkle & Cheever, 2014). o Side effects: pulmonary edema, heart failure, tachycardia, nausea, vomiting, confusion, headache, blurred vision (Vallerand, Sanoski, & Deglin, 2015).
• Inotropic agents (dobutamine or