An injury can cause a significant damage to a person. In Oliver’s case, the damage led to a cerebral disorder. There are several numbers of cerebral disorders that may cause a raised intracranial pressure. This includes intracranial haemorrhage and fracture. It is a challenging task for nurses and the multidisciplinary health team to manage, control and prevent secondary injury to the patient. This case study will present how a motor vehicular accident can cause a great impact on a healthy young adult with no medical history and how a head injury can affect multiple systems in the human body. The aim of the case study is to critically analyse and discuss the nursing complex care for Oliver who was diagnosed with an intra cerebral hematoma
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Management and considerations of a patient with raised intracranial pressure due to traumatic brain injury will be discussed.
The CT scan results reported that Oliver has a skull fracture and intracranial haematoma. Traumatic brain injury (TBI) can cause damage to the skull and brain tissue. Primary injury occurs on the time of impact, which includes a fracture in the skull, brain tissue lacerations and rupture of vessels. The secondary injury may later on manifest and are the result of the primary injury, which includes hematoma formation caused by the rupture of vessels and increased intracranial pressure. The mentioned injuries can lead to the interruption of neuronal function and disequilibrium state. The common cause of TBIs is vehicular accidents. Subsequent to Oliver’s neurological surgery, invasive measures are to be applied in monitoring intracranial pressure (ICP). An elevated ICP causes a critical reduction in cerebral perfusion pressure (CPP) and cerebral blood flow (CBF), which can lead to secondary ischaemic cerebral injury. Intracranial hypertension should not be prolonged, a number of studies show that an increase in ICP is strongly …show more content…
Neurological assessments are highly important to evaluate Oliver’s baseline neurological status, which can signal changes and indicate deterioration for immediate and early intervention. Timely monitoring of pupillary response is highly important for early detection and prevention of Cushing’s triad (Morton & Fontaine, 2013; Perrin, 2009). According to LeMone et al. (2011), indication point of deterioration appears in the sudden changes in neurological status. An increase in temperature with increased oxygen consumption may result to increases intracranial pressure. The status of the midbrain and pons is mirrored by pupillary responses. Also, the function of the cranial nerves IX and X and protective mechanisms such as cough and gag reflexes may be compromised due to the pressure on the brainstem. The three signs, which include increased mean arterial pressure (MAP), increased pulse pressure and bradycardia is known as Cushing’s triad, which can be a signal to notify that the brainstem’s final effort to maintain cerebral perfusion. The said manifestations are late and irreversible. (LeMone, Burke & Bauldoff, 2011). Elevation of the head of the bed from 0 to 30 degrees as prescribed; for the maintenance of the alignment of the head and neck in a neutral position An increased ICP can be triggered by the restriction of venous drainage from the head
Management and considerations of a patient with raised intracranial pressure due to traumatic brain injury will be discussed.
The CT scan results reported that Oliver has a skull fracture and intracranial haematoma. Traumatic brain injury (TBI) can cause damage to the skull and brain tissue. Primary injury occurs on the time of impact, which includes a fracture in the skull, brain tissue lacerations and rupture of vessels. The secondary injury may later on manifest and are the result of the primary injury, which includes hematoma formation caused by the rupture of vessels and increased intracranial pressure. The mentioned injuries can lead to the interruption of neuronal function and disequilibrium state. The common cause of TBIs is vehicular accidents. Subsequent to Oliver’s neurological surgery, invasive measures are to be applied in monitoring intracranial pressure (ICP). An elevated ICP causes a critical reduction in cerebral perfusion pressure (CPP) and cerebral blood flow (CBF), which can lead to secondary ischaemic cerebral injury. Intracranial hypertension should not be prolonged, a number of studies show that an increase in ICP is strongly …show more content…
Neurological assessments are highly important to evaluate Oliver’s baseline neurological status, which can signal changes and indicate deterioration for immediate and early intervention. Timely monitoring of pupillary response is highly important for early detection and prevention of Cushing’s triad (Morton & Fontaine, 2013; Perrin, 2009). According to LeMone et al. (2011), indication point of deterioration appears in the sudden changes in neurological status. An increase in temperature with increased oxygen consumption may result to increases intracranial pressure. The status of the midbrain and pons is mirrored by pupillary responses. Also, the function of the cranial nerves IX and X and protective mechanisms such as cough and gag reflexes may be compromised due to the pressure on the brainstem. The three signs, which include increased mean arterial pressure (MAP), increased pulse pressure and bradycardia is known as Cushing’s triad, which can be a signal to notify that the brainstem’s final effort to maintain cerebral perfusion. The said manifestations are late and irreversible. (LeMone, Burke & Bauldoff, 2011). Elevation of the head of the bed from 0 to 30 degrees as prescribed; for the maintenance of the alignment of the head and neck in a neutral position An increased ICP can be triggered by the restriction of venous drainage from the head