Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 3512 acute & chronic > Week 11 TBI/Brain Tumors > Flashcards

Week 11 TBI/Brain Tumors Flashcards

1
Q

How do we diagnose TBI?

A

CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the two signs that someone has a basal skull fracture?

A
  1. battles sign (post auricular ecchymosis - behind the ear)
  2. Raccoon eyes (bilateral periorbital ecchymosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a common complication of facial and skull fractures?

A

Dural Tear - CSF leak = meningitis risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do we check for CSF leak in facial and skull fractures?

A

look for clear fluid coming from nose or ears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a major risk of skull fracture?

A

Meningitis - monitor for S&S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What tube should we NEVER insert with a facial/skull fracture and why?

A

NG
can go into the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do we know if someone has CSF leak?

A

Halo sign
- use gauze - will see red in middle and yellowish around

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a focal head injury?

A

Contusion
- bruising of brain tissue in a focal area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can focal head injury lead to?

A

increased ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a coup?

A

Primary impact (think baseball bat hitting a head)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a contrecoup?

A

secondary impact
(baseball bat hits head and then brain hits back of head)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is coup-contre coup?

A

acceleration-deceleration injury
contusions at the site of direct impact and seondary damage on opposite side from force of impact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What medical issue is common in contusion?

A

Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Diffuse Axonal injury (DAI)?

A

sheering of axons - widespread damage
mild- concussion or severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What % of people remain in a vegetative state with severe DAI?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When can a DAI occur after initial TBI?

A

12-24 hours

16
Q

What two things can DAI cause in the head?

A
  1. cerebral edema
  2. increased ICP
17
Q

What two brain injuries can happen simultaneously?

A

Focal head injury + DAI

18
Q

What are the two types brain bleeds?

A
  1. Epidural Hematoma
  2. Subdural Hematoma
19
Q

Which type of hematoma is emergent and why?

A

Epidural hematoma
b/c it’s arterial = bleeds fast= rapid IICP

20
Q

what is the intervention for epidural hematoma?

A

immediate surgery to remove bleed - craniotomy
(nurse care for IICP)

21
Q

What Hematoma is kinda tricky and why?

A

Subdural Hematoma
b/c it can go undetected
usually venous

22
Q

Which hemotoma is arterial and which is venous?

A

epidural= arterial
subdural= venous

23
Q

What is an important question to ask to check about subdural hematoma?

A

“have you fallen in the last 6 months? “

24
Q

what is the intervention for subdural hematoma?

A

surgery to remove the bleed

25
Q

what do we do at the scene of an MVA as a bystander?

A

Calm gentle approach
Patent airway
Stabilize cervical spine until x-ray
Apply pressure to external bleeding
Warm blankets
Assess for rhinorrhea/ottorrhea, scalp wounds

26
Q

What happens if a person has head injury from an MVA at the hospital?

A
  1. O2 - NP or rebreathe
  2. 2 large bore IVs - careful with fluid
    - meds to decrease ICP
    - meds to increase CPP
    - meds to control pain
    - meds to prevent/control seizures
  3. keep them warm
  4. frequent VS neuro checks (ICP & CPP)
  5. Support patient and family
  6. prep for surgery if needed
27
Q

What are the 4 types of brain tumors?

A
  1. Primary - from tissue in the brain
  2. Secondary - from malignant neoplasm/tumour elsewhere
  3. Benign (encapsulated) tumor
  4. Malignant (invasive) - glioblastoma
28
Q

What are 2 clinical manifestations of brain tumors?

A
  1. headache (dull)
  2. S&S of IICP
29
Q

What are the 6 interventions for brain tumors and what do they do?

A
  1. Corticosteroids to decrease inflammation
    dexamethasone (Decadron) – IV /PO

2.Ventricular Shunts to decrease hydrocephalus
-To drain CSF from ventricles to R Atrium or peritoneum
-Cerebral palsy typically

  1. Surgery to remove or debulk mass
    Craniotomy
    Stereotactic radiosurgery (high dose radiation precisely delivered)
  2. Radiation (internal, external)
  3. Chemotherapy
    Can be oral, IV, intrathecally (resevoir placed in crainial ventricle & fill brain)
  4. Nursing care for IICP- keep that ICP down!
30
Q

What is a craniotomy?

A

bone flap removed

31
Q

what is included in craniotomy post op care?

A
  1. close monitor ICP
  2. maintain CPP
  3. Assess, prevent and treat complications
  4. prevent infection/do dressings
  5. Pain & nausea control
  6. antiseizure meds
32
Q

What are complications of craniotomy?

A
  1. PN
  2. stress
  3. gastric ulcer
  4. DVT/PE
  5. Constipation
  6. Fluid & lytes imbalance
  7. SIDH
  8. DI
33
Q

What is a common issue in patients with brain injury that affects the whole family?

A

personality changes

34
Q

What is a common surgery option for subdural hematoma?

A

Burr hole

35
Q

What is sterotactic surgery?

A
  1. Stereotactic Radiosurgery - radiation to destroy brain tumour - gamma knife
  2. Stereotactic Bx/Surgery- biopsy, small tumors, abscesses

NURS 3512 acute & chronic (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions