Traumatic Brain Injury Overview
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Questions and Answers

What is a primary indication of impending brain herniation?

  • Dilated pupils (correct)
  • Decreased intracranial pressure
  • Regular pulse
  • Normal respiratory rate

Which medication is used to draw fluid from the brain into the bloodstream for acute cerebral edema?

  • Furosemide
  • Pentobarbital
  • Mannitol (correct)
  • Phenytoin

Which of the following requires monitoring for electrolyte and fluid status due to its diuretic effect?

  • Barbiturate
  • Pentobarbital
  • Mannitol (correct)
  • Phenytoin

What type of respiratory pattern may indicate an increased ICP?

<p>Cheyne-Stokes respirations (A)</p> Signup and view all the answers

What is the purpose of maintaining a calm environment for a patient with increased ICP?

<p>To limit noise and stress (A)</p> Signup and view all the answers

Which of the following actions should be avoided to prevent further increases in ICP?

<p>Prolonged suctioning (C)</p> Signup and view all the answers

What is a common complication of brain herniation related to altered consciousness?

<p>Deteriorating level of consciousness (A)</p> Signup and view all the answers

What is the priority action for a nurse caring for a client who was admitted following a motor vehicle crash and may have a cervical spine injury?

<p>Keep neck stabilized (B)</p> Signup and view all the answers

During the assessment of a client after surgical evacuation of a subdural hematoma, which assessment should be prioritized?

<p>Glasgow Coma Scale (C)</p> Signup and view all the answers

Which findings during an admission assessment indicate increased intracranial pressure (ICP) for a client with a gunshot wound to the head?

<p>Bradycardia (B), Headache (C), Dilated pupils (D)</p> Signup and view all the answers

What is a common adverse effect associated with electrolyte imbalances in patients following trauma?

<p>Hyponatremia (A)</p> Signup and view all the answers

In monitoring a client with a closed head injury and ICP of 16 mmHg, which of the following actions should be avoided?

<p>Perform frequent suctioning (D)</p> Signup and view all the answers

What is a critical reason for keeping a cervical spine immobilized in a client who may have a spinal injury?

<p>To prevent permanent spinal cord damage (B)</p> Signup and view all the answers

When assessing for signs of increased ICP, which symptom is least likely to be associated?

<p>Hypotension (C)</p> Signup and view all the answers

What score indicates a patient is able to obey commands in the Glasgow Coma Scale (GCS) motor response?

<p>6 (A)</p> Signup and view all the answers

Which type of skull fracture is most common and typically results from a large impact?

<p>Linear skull fracture (D)</p> Signup and view all the answers

What is a common symptom associated with a basilar skull fracture?

<p>Raccoon’s eyes (B)</p> Signup and view all the answers

Which statement accurately describes a decerebrate posturing response?

<p>Extension and internal rotation in response to pain (D)</p> Signup and view all the answers

What is the most common type of diffuse injury that ultimately leads to brain injury and potentially death?

<p>Diffuse axonal injury (D)</p> Signup and view all the answers

What would be considered a late sign of increased intracranial pressure (IICP)?

<p>Cushing’s triad (B)</p> Signup and view all the answers

What action could potentially increase intracranial pressure in a patient with TBI?

<p>Rapid administration of IV fluids (C)</p> Signup and view all the answers

What is the purpose of a craniotomy in the context of traumatic brain injury treatment?

<p>To create an opening for evacuation of clots (B)</p> Signup and view all the answers

What role does osmotic diuresis play in managing increased ICP?

<p>It decreases cerebral edema (B)</p> Signup and view all the answers

Which of the following is not a cause of traumatic brain injury (TBI)?

<p>Regular exercise (C)</p> Signup and view all the answers

What type of hematoma develops in the space between the dura mater and the skull?

<p>Epidural hematoma (B)</p> Signup and view all the answers

Which mechanism of injury is described as damage caused by the head hitting an object leading to brain rebound effects?

<p>Coup injury (B)</p> Signup and view all the answers

Which of the following symptoms is often associated with mild concussion?

<p>Immediate loss of consciousness (A)</p> Signup and view all the answers

In which scenario is a patient likely to be admitted for observation after experiencing a concussion?

<p>Loss of consciousness for more than 2 minutes (D)</p> Signup and view all the answers

Flashcards

GCS Motor Response

A scale used to assess the level of consciousness and motor function in a patient with a brain injury.

GCS Motor Score 6

The patient obeys commands and performs purposeful movements.

GCS Motor Score 5

The patient localizes pain with purposeful movement, reaching towards the source of pain.

GCS Motor Score 4

The patient withdraws from painful stimulation by pulling away.

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GCS Motor Score 3

The patient demonstrates abnormal flexion (decorticate) posturing in response to pain.

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GCS Motor Score 2

The patient exhibits abnormal extension (decerebrate) posturing in response to pain.

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GCS Motor Score 1

Absence of motor response to any painful stimulation.

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Traumatic Brain Injury (TBI)

An injury to the brain caused by a blow or jolt to the head.

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Epidural Hematoma

A collection of blood between the dura mater and the skull, often caused by a skull fracture.

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Subdural Hematoma

A collection of blood between the dura and arachnoid mater.

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Intracerebral Hematoma

A brain bleed within the brain tissue itself.

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Intracranial Pressure (ICP)

The pressure within the skull.

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Cushing's Triad

A late sign of increased intracranial pressure, characterized by bradycardia, hypertension and irregular respiration.

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Skull Fracture

A break in the bone of the skull.

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Basilar Skull Fracture

Fracture of the bones at the base of the skull

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Bradycardia

Slow heart rate

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Increased ICP

Elevated intracranial pressure

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Cheyne-Stokes respirations

Irregular breathing pattern

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Herniation

Brain tissue shifting due to swelling

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Mannitol

Osmotic diuretic for cerebral edema

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Phenytoin

Anticonvulsant for seizure control

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Hyperventilation

Increased breathing rate for decreased ICP

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Monitor fluid status

Important to watch for dehydration or excess fluid

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Priority after MVC

Stabilize the neck to prevent spinal injury.

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Priority after subdural hematoma

Assess airway, breathing, and circulation first.

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Decreasing ICP in head injury

Elevate head/neck 30 degrees or neutral position, minimize noise, keep hydrated, but avoid overhydration

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Increased ICP signs

Headache, dilated pupils, tachycardia, and decorticate posturing.

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GSW Head Injury Assessment Priority

Assess for headache, dilated pupils, tachycardia, and decorticate posturing.

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Increased ICP Danger Sign (Pupil)

Dilated pupils may indicate increased intracranial pressure.

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Increased ICP Danger Sign (Pulse)

Bradycardia (slow pulse)

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Increased ICP Danger Sign(Blood Pressure)

Hypertension (high blood pressure).

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Study Notes

Impending Brain Herniation

  • A primary indication of impending brain herniation is pupillary dilation.

Fluid Management

  • Mannitol is frequently used to draw fluid from the brain into the bloodstream for acute cerebral edema.

Diuretic Effects

  • Mannitol requires monitoring for electrolyte and fluid status due to its diuretic effect.

Respiratory Patterns

  • Cheyne-Stokes respiration, characterized by periods of apnea followed by increasingly deeper breaths, may indicate an increased ICP.

Environmental Considerations

  • Maintaining a calm environment for a patient with increased ICP is critical.

ICP Prevention Measures

  • Avoid suctioning or coughing, as these actions can further increase ICP.

Brain Herniation Complications

  • A common complication of brain herniation related to altered consciousness is coma.

Cervical Spine Injury Management

  • The priority action for a nurse caring for a client who was admitted following a motor vehicle crash and may have a cervical spine injury is to maintain cervical spine immobilization.

Subdural Hematoma Assessment

  • During the assessment of a client after surgical evacuation of a subdural hematoma, neurological function should be prioritized.

Increased Intracranial Pressure (ICP)

  • Findings during an admission assessment indicating increased intracranial pressure (ICP) for a client with a gunshot wound to the head include decreased level of consciousness, headache, vomiting, and pupillary changes.

Electrolyte Imbalance

  • Seizures are a common adverse effect associated with electrolyte imbalances in patients following trauma.

ICP Management

  • Avoid hyperventilation in a client with a closed head injury and an ICP of 16 mmHg.

Cervical Spine Immobilization

  • Keeping a cervical spine immobilized in a client who may have a spinal injury is critical to prevent further damage.

ICP Assessment

  • Bradycardia is the least likely symptom associated with increased ICP.

Glasgow Coma Scale (GCS)

  • A GCS score of 5 indicates a patient is able to obey commands in the motor response section.

Skull Fracture Classification

  • Linear skull fractures are the most common and typically result from a large impact.

Basilar Skull Fracture Symptoms

  • Battle's sign (bruising behind the ear) and raccoon eyes (bruising around the eyes) are common symptoms associated with a basilar skull fracture.

Decerebrate Posturing

  • Decerebrate posturing is defined as extension of the arms and legs, with the wrists and fingers flexed, in response to pain or external stimuli.

Diffuse Brain Injury

  • Diffuse axonal injury is the most common type of diffuse injury that ultimately leads to brain injury and potentially death.

Late Signs of IICP

  • Cushing’s triad is a late sign of increased intracranial pressure (IICP) and consists of hypertension, bradycardia, and irregular respirations.

Potential ICP Increase

  • Hypertension could potentially increase intracranial pressure in a patient with TBI.

Craniotomy Purpose

  • A craniotomy in the context of traumatic brain injury treatment is performed to relieve pressure from bleeding or edema, remove a hematoma, or repair damaged blood vessels.

Osmotic Diuresis

  • Osmotic diuresis plays a role in managing increased ICP by drawing fluid from the brain into the bloodstream, thus reducing intracranial pressure.

TBI Causes

  • Hypoglycemia is not a cause of traumatic brain injury (TBI).

Epidural Hematoma Location

  • An epidural hematoma develops in the space between the dura mater and the skull.

Mechanism of Injury

  • Coup-contrecoup injury is described as damage caused by the head hitting an object leading to brain rebound effects.

Mild Concussion Symptoms

  • Headache, dizziness, and nausea are often associated with mild concussion.

Concussion Observation Criteria

  • A patient who experiences a concussion and has loss of consciousness, neurological impairment, or focal neurological deficits is likely to be admitted for observation.

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Neuro, TBI, ICP (RNUR 2050) PDF

Description

This quiz covers the essential aspects of Traumatic Brain Injury (TBI), including its causes, mechanisms of injury, and types of skull fractures. Understanding TBI is crucial as it is a leading cause of death and disability, particularly in younger populations. Test your knowledge on how TBIs occur and their implications.

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