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32 Cards in this Set
- Front
- Back
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At what time do deaths occur from head injury? |
Immediately after Within 2 hours Within 3 weeks |
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What's the difference between Coup and Contrecoup? |
Coup is when the brain flies forward Contrecoup is when the brain flies back, after flying forward |
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What are the signs of an Anterior fossa basal skull fracture? |
Rhinorrea (runny nose) Bilateral ecchymotic eyes May have injury to CN I May have facial fractures |
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What are the signs of a Middle fossa basal skull fracture? |
Otorrhea or Rhinorrea Battle signs (echhymosis over mastoid bone) May have cranial nerve damage |
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What are the signs of posterior fossa basal skull fracture? |
May have epidural hematoma Cerebellar, brain stem, or cranial nerve damage signs Visual changes, tinnitis, facial paralysis, conjugate eye deviation |
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Should you intubate through the nose if you suspect a basal skull fracture? |
Nope |
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What is the halo effect in CSF? |
When there's blood surrounded by some CSF which indicates bleeding. Another way to test it is if CSF tests positive for glucose. |
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1. May involve dural tear with CSF ottorrhea, vertigo, and battles sign a.Cerbral contusionb.Cerebral concussionc.Frontal lobe skull fractured.Basilar skull fracture |
D. Basilar skull fracture |
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2. An individual hits their forehead in a MVC. The coup/contrecoup would be in the a.Frontal/parietal regionb.Frontal/occipital regionc.Parietal/temporal regiond.Occipital/frontal region |
B. Frontal/occipital region |
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How do you minimize CSF leakage? |
Have the bed flat (concern is that it'll raise ICP, so discuss with physician before) Never suction orally Place sterile gauze or cotton ball around area Verify csf leak by testing for glucose Monitor respiratory status |
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What are symptoms of a concussion? |
Confusion and amnesia Brief loss of consciousness headache dizziness lack of awareness of surroundings nausea and vomiting |
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Post-concussion syndrome is defined as |
2 weeks to 2 months (post injury?) persistent headache lethargy personality and behavioral changes dizziness |
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What are some s/s of a past head injury? |
fatigue irritability anxiety insomnia loss of concentration and memory noise and light sensitivity |
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What are clinical manifestations of Diffuse Axonal injury (DAI)? |
Decreased LOC Increased ICP Abnormal posturing Global cerebral edema |
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Are the layers of the brain intact for a cerebral contusion? T/F |
True
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Are they intact for a cerebral laceration? |
False |
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What is an epidural hematoma? |
Bleeding between the skull and the dura layer |
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What indicates an epidural hematoma? |
Brief loss of consciousness headache increasing irritability and confusion rapid deterioration decreasing loc ipsilateral occulomotor paralysis contralateral hemiparesis/hemiplegia |
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What kind of events bring about DAI? |
Shaking baby syndrome |
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What kind of events bring epidural hematoma? |
sports falls car crashes |
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What is a subdural hematoma |
Occurs between the dura mater and arachnoid layer of the meningeal layers of the brain |
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What does a pt with subdural hematoma look like? |
Drowsy and confused Ipsilateral occulomotor paralysis |
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How many hours after the injury would you expect symptoms to appear? |
48 hours |
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When does subacute subdural hematoma's develop> |
2-14 days after injury |
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What is a possible indicator of subacute subdural hematoma? |
Failure to regain consciousness |
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What are the diagnostic tests for pt with head trauma? Which one is the best one? |
CT scan (the best one) MRI Cervical Spine x-ray GCS scale |
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What are your nursing assessment priorities? |
GCS Score Neurological status Presence of CSF leak
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What are the Nursing dx for head trauma? |
Ineffective tissue perfusion Hyperthermia Acute pain Anxiety Impaired physical mobility |
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A pt is hit by a bat. They have a loss of consciousness and then are lucid followed by a rapid in their neuological status. What might they have? |
Epidural hematoma |
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A pt has a subacute hematoma with a depressed parietal skull fx you would anticipate |
Pt will be taken to surgery for craniotomy for evacuation of blood |
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A pt returns from the OR post craniotomy has an ICP monitor with an intraventricular catheter a priority intervention is a.Aseptic technique to prevent infection b.Constant monitoring of icp waveforms c.Removal of CSF to maintain normal ICP
d.Sampling of CSF to determine abnormalities |
idk... im thinking either C or D |
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Bilateral ecchymotic eyes may be seen in what type of fx |
Anterior |
