NR 340 Week 7 Case Study – Neuro
NR 340 Week 7 Case Study – Neuro
Ms. J, a 27 year-old right-handed patient, was involved in a motor vehicle collision. Ms. J was an unrestrained passenger in a car that swerved off the road and struck a tree. She was ejected from the car and was found unconscious by the emergency medical service personnel.
After being placed on a spinal board and placed in a cervical collar, she was transported by helicopter to the nearest trauma
- Identify the leading causes of head injury.
- What was the rationale of placing Ms. J on a backboard and cervical collar?
- What is the Glasgow Coma Scale? How is the scale helpful?
- Identify special considerations that are necessary for patients with basilar skull fractures for placement of an endotracheal or nasogstric tube? What clinical manifestations can be seen with basilar skull fractures?
- Discuss the significance of a midline shift?
- Identify the types of SDHs. Include the pathology and presentation of SDH.
- What surgical intervention is indicated for patients with SDH?
- Define ICP. What methods are available for monitoring ICP? Describe the potential complications of ICP monitoring. How can the nurse prevent those complications?
- List and describe possible secondary injuries with head injury. List interventions that will prevent secondary brain injury.
- Based on Ms J’s arterial blood gas results, what ventilator changes should be anticipated?
- Given an ICP of 25 mmHg and a blood pressure of 120/72, calculate Ms J’s cerebral perfusion pressure (CPP). Is the CPP an acceptable value?
- Discuss the collaborative management that should be anticipated for patients with head injuries. Include the rationale and identify at least one potential complication associated with each.
- Define and discuss the clinical significance of posturing such as abnormal flexion and abnormal extension.
- Describe the relevance of controlling hyperthermia in the management of patients with head injuries.
- Which cranial nerves must be intact before a patient can eat or drink?
- What are the potential intracranial effects of increased ICP?
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