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brain injury > care of clients with neurologic trauma > Flashcards

care of clients with neurologic trauma Flashcards

1
Q

what are the types of head injuries

A

scalp injury
skull fractures

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2
Q

what are the types of brain injuries

A

concussion
contusion

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3
Q

what are the mechanisms of injury

A

primary injury

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4
Q

the consequence of direct contact to the head/brain during the instant of initial injury, causing extracranial focal injuries

A

primary injury and secondary injury

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5
Q

evolves over the ensuing hours and days after the initial injury and results from inadequate delivery of nutrients and oxygen in the cells

A

secondary injuries

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6
Q

any damage to the head as a result of trauma

A

head injuries

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7
Q

may range from minor injury to a life-threatening emergency

A

scalp injury

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8
Q

why do scalp bleed profusely when injured

A

because scalp vessels constrict poorly

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9
Q

what is the management for scalp abrasion (minor scalp injury)

A
  1. was wounded area with mild soap and water
  2. apply pressure for 10 minutes
  3. apply ice compress for 20 minutes
  4. monitor for signs of increased icp
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10
Q

what are the signs of increased icp

A

headache
restlessness
anisocoria
altered level of consciousness

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11
Q

what is the management for scalp laceration (major scalp injury)

A
  1. irrigate area with sterile NSS
  2. control bleeding
    2.a. apply direct pressure
  3. assist in laceration closure
    3.a. primary closure using staples or sutures
    3.b. delayed closure for wounds greater than 24 hours
  4. monitor for signs of increased ICP
  5. administer antibiotics and tetanus toxoid as ordered
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12
Q

when should we give a dose of tetanus toxoid

A

when the last dose was >5 years ago

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13
Q

a break in the continuity of the skull caused by forceful trauma

A

skull fractured

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14
Q

what are the types of skull fracture

A

linear (simple)
comminuted
depressed

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15
Q

what skull fracture is the break in the continuity of the bone

A

linear or simple

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16
Q

what type of skull fracture is splintered or multiple fracture lines

A

comminuted

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17
Q

what type of skull fracture has the bones of the skull forcefully displaced downward

A

depressed

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18
Q

what are the locations of skull fracture

A

frontal
temporal
basilar

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19
Q

what are the clinical manifestations of skull fracture

A

signs of local injury
persistent localized pain

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20
Q

how does basilar skull fracture produce hemorrhage from the nose, pharynx, ears, and under the conjunctiva

A

this is because basilar skull fractures tend to traverse the paranasal sinus of the frontal bone or the middle ear located in the temporal bone

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21
Q

what are the signs of basilar skull fracture

A

battle sign
racoon eyes
conjunctival hemorrhage

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22
Q

what are the signs of CSF leakage

A

CSF otorrhea
CSF rhinorrhea

23
Q

what should you look for in blood to confirm CSF leakage

A

the halo sign

24
Q

what appears in the blood that ensures a positive halo sign

A

yellowish ring around blood

25
Q

what are the diagnostics for skull fracture

A

computed tomography scan
magnetic resonance imaging

26
Q

what does computed tomography scan do to a skull fracture

A

reveals fractured area

27
Q

what does magnetic resonance imaging do to skull fracture

A

provides a better resolution and clearer pictures of uninjured area

28
Q

what are the management for nondepressed skull fractures

A

close monitoring until brain injury is ruled out
symptomatic treatment

29
Q

what are the management for depressed or comminuted skull fractures

A

surgical elevation of skull and debridement within 24 hours of injury

30
Q

what are the parts of the brain

A

cerebrum
cerebellum
brain stem

31
Q

what should be considered in the event of any head injury

A

brain injury

32
Q

what are the mechanisms of brain injury

A

traumatic brain injury, blunt (closed)
traumatic brain injury, penetrating (open)

33
Q

occurs when the head accelerates and then rapidly decelerates or collides with another object and brain tissue is damaged but there is no opening through the skull and dura

A

traumatic brain injury, blunt (closed)

34
Q

occurs when an object penetrates the skull, enters the brain, and damages the soft brain tissue in its path or when blunt trauma to the head is so severe that it opens the scalp, skull, and dura to expose the brain

A

traumatic brain injury, penetrating (open)

35
Q

causes of brain injuries

A

direct impact brain injury
acceleration-deceleration brain injury
blast brain injury

36
Q

what are the types of brain injury

A

contusion
concussion
hemorrhage

37
Q

a single, specific area of the brain is bruised and damaged

A

cerebral contusion

38
Q

a contusion that is present at both the site of impact and at the exact opposite ends of each impact

A

coup-contrecoup injury

39
Q

brain damage at the site of the impact

A

coup traumatic brain injury

40
Q

brain damage at the opposite side of the impact

A

counter-coup traumatic brain injury

41
Q

what are the manifestations of cerebral contusion

A

loss of consciousness
confusion/stupor

42
Q

what are the management of cerebral contusion

A

close monitoring
mannitol IV if with signs of increased ICP
bed rest
symptomatic and supportive treatment

43
Q

temporary loss of neurologic function with no apparent structural damage to the brain

A

concussion

44
Q

what are the specific causes of cerebral concussions

A

falls
motor-vehicular accidents
violent assaults
contact sports
history of prior concussion

45
Q

what are the physical manifestations of cerebral concussion

A

headache
nausea
vomiting
balance problems
dizziness
visual problems
fatigue
photophobia
phonophobia
numbness/tingling
feeling dazed
feeling stunned

46
Q

what are the cognitive symptoms of cerebral concussion

A

feeling mentally “foggy”
feeling slowed down
difficulty concentrating
difficulty remembering
forgetfulness of recent information
confusion about recent events
answering questions slowly
repeating questions

47
Q

what are the emotional manifestations of cerebral concussion

A

irritability
sadness
anxiety
increased emotional lability
nervousness

48
Q

what are the sleep-related manifestations of cerebral concussion

A

drowsiness
difficulty falling asleep
sleeping more or less than usual

49
Q

how many days does a patient recover from cerebral concussion

A

7-10 days

50
Q

how many weeks does some symptoms continue to manifest after the recovery

A

2 to 4 weeks

51
Q

what do other patients develop after recovery from cerebral concussion

A

post-concussion syndrome

52
Q

what are the management for cerebral concussion

A

admission may be necessary for monitoring
monitoring of altered level of consciousness
supportive and symptomatic care
instruct to gradually return to non-sport activities after no more than 2-3 days of rest if discharged

53
Q

what should u take note when monitoring for altered level of consciousness in patients with cerebral concussion

A

worsening headaches
dizziness
seizures
abnormal pupil response
vomiting

54
Q

supportive and symptomatic care

A

brain injury (3 decks)

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