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NR 305 Week 3 Discussion Topic, Assessment of the Neurological System

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NR 305 Week 3 Discussion Topic, Assessment of the Neurological System

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NR 305 Week 3 Discussion Topic, Assessment of the Neurological System




Assessment of the Neurological System (graded) Randy Adams is a 38-year-old
male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-
hour observation for mild concussion following a motor vehicle accident. Randy
lost consciousness during the accident and was very confused when he arrived in
the ER after EMS transport. He is an Iraq war veteran and he seemed to think after
the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy
has some residual problems from a couple of explosive incidents that occurred
while he was in Iraq. The physician is unsure whether Randy's current symptoms
are from the car accident or from prior injuries so he has referred him for
consultations to both a neurologist and to a behavioral health specialist.
Based on the above please discuss the following.
1. Pathophysiology of concussive injuries and treatment
2. Neurological assessment tools used in your current practice setting (if not
presently working, please describe one used during prior employment or
schooling)
3. Current best practices associated with post-traumatic stress disorder
(PTSD)
4. Nursing interventions you would include in this patient's plan of care



Dear Professor and Class,
Marieb and Hoehm (2013), defines concussion "as an alteration in brain function, usually
temporary, following a blow to the head”. This may be with or without loss of consciousness. "In
rare cases flashbacks occur in which the person behaves for minutes, hours or days as if the
trauma were occurring again” (Marieb & Hoehm, 2013, p.404). In this case, it appears Randy
could certainly be experiencing flashbacks. Almasi 2012 states, “The most common mechanism
of head injury is dynamic loading caused by either direct impact to the head or by impulse, a
sudden movement of the head produced by an impact elsewhere. Both impact and impulse
injuries produce acceleration forces that can damage the brain. It appears that rotation of the head
is necessary to produce diffuse lesions in the brain, causing concussion.” Some of the symptoms
that may present are; headache, nausea, vomiting, light sensitivity, changes in reaction time and
balance and changes in memory, judgment or speech. The CDC’s recommendations for
treatment for concussion mostly includes: Rest and avoidance of activities that are physically
demanding, or require a lot of concentration. They can make your symptoms worse and slow
your recovery. Avoid activities, such as contact or recreational sports, that could lead to another

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