10/16/24, 1:46 Head injury - Lecture notes Lecture
PM notes
MEDICAL SURGICAL NURSING: NEURO 1.9.5 NURSE ANGIE 2018
HeAd INJUrY
Trauma to the skull such as jarring, shaking or laceration can lead to mild or extensive brain damage.
Assessment
‣ Assessment finding will vary
depending on the type and severity
Concussion: A brain injury caused by a blow to of the head injury.
the head or a violent shaking of the head and body. ‣ Increased ICP
‣ LOC changes
This is a closed type of head injury. ‣ Altered mental status
Contusion: Bruising or bleeding on the brain due to ‣ Airway and breathing changes
localized trauma.This is also a closed head injury. ‣ Vital signs will show
increased ICP
Closed head injury: Traumatic brain injury in where
‣ Visual changes
the skull and dura mater remain intact. These are the ‣ Pupillary changes and papilledema
leading cause of death in children under 4 years old ‣ Nuchal Rigidity
and the most common cause of physical disability and cognitive impairment in young people. ‣ CSF drainage
‣ Weakness and paralysis
Basilar Skull Fracture: Is a fracture of the base of the skull, typically involving the
‣ Posturing
temporal bone, occipital bone, sphenoid bone, and/or ethmoid bone. These are very ‣ Decreased sensation
uncommon. Can be a closed fracture. ‣ Reflex changes
Epidural Hematoma: Bleeding occurs between the skull and the dura (the brain cover). ‣ Seizure activity
Treatments
The bleeding is from an injury to a vein or a branch of the posterior meningeal artery. The Minor Injury: Repair CSF
‣
most dangerous type of hematoma leak, lacerations of the
Subdural hematoma: Known as a subdural hemorrhage (SDH), is a type of hematoma, usually scalp
associated with traumatic brain injury. Blood gathers between the inner layer of the dura mater and ‣ Penetrating wounds: Surgical
the arachnoid mater. repair and antibiotics
Intracerebral Hematoma: Blood leaks into the brain as a result of head trauma or ‣ Moderate to severe head injury:
supportive care, prophylactic
spontaneously. Subarachnoid Hemorrhage: Bleeding into the subarachnoid space. Can be
antiseizure medications, prevent and
caused by ruptured aneurysm or trauma
control intracranial hypotension,
prevent brain damage from
hypotension , prevent anemia,
Increased arterial Carbon Dioxide
levels.
COMPLICATIO EDUCATION INTERVENTIONS ‣ Administer Glucocorticoids:
Dexamethasone, mannitol and
NS Educate the client and ‣ Monitor respiratory status and furosemide these are hypertonic
family on possible behavior maintain patent airway,
‣ Cerebral bleeding solutions that will pull fluid from the
increased C02 levels cause
‣ Hematoma changes, the long term cerebral edema. brain and decrease intracranial
‣ Uncontrollable ICP effects of a traumatic brain ‣ Monitor vitals & pressure.
‣ Infections injury and when to contact Temperature Monitor neuro
status ‣ Barbiturate therapy: Decreases cerebral
‣ Seizures
the HCP ‣ Monitor for signs of ICP metabolic weight.
‣ CSF leakage
‣ Mental status changes ‣ Keep head elevated to reduce ‣ Morphine Sulfate: Decreases agitation
venous pressure
‣ Behavioral changes and restlessness, administer with
‣ Prevent neck flexion
‣ Cranial nerve deficits caution because it can cause respiratory
‣ Initiate normothermia measures.
‣ Assess for pain and restlessness. depression which will also cause ICP.
‣ Monitor for CSF drainage
1
about:blan 1/
k 2
PM notes
MEDICAL SURGICAL NURSING: NEURO 1.9.5 NURSE ANGIE 2018
HeAd INJUrY
Trauma to the skull such as jarring, shaking or laceration can lead to mild or extensive brain damage.
Assessment
‣ Assessment finding will vary
depending on the type and severity
Concussion: A brain injury caused by a blow to of the head injury.
the head or a violent shaking of the head and body. ‣ Increased ICP
‣ LOC changes
This is a closed type of head injury. ‣ Altered mental status
Contusion: Bruising or bleeding on the brain due to ‣ Airway and breathing changes
localized trauma.This is also a closed head injury. ‣ Vital signs will show
increased ICP
Closed head injury: Traumatic brain injury in where
‣ Visual changes
the skull and dura mater remain intact. These are the ‣ Pupillary changes and papilledema
leading cause of death in children under 4 years old ‣ Nuchal Rigidity
and the most common cause of physical disability and cognitive impairment in young people. ‣ CSF drainage
‣ Weakness and paralysis
Basilar Skull Fracture: Is a fracture of the base of the skull, typically involving the
‣ Posturing
temporal bone, occipital bone, sphenoid bone, and/or ethmoid bone. These are very ‣ Decreased sensation
uncommon. Can be a closed fracture. ‣ Reflex changes
Epidural Hematoma: Bleeding occurs between the skull and the dura (the brain cover). ‣ Seizure activity
Treatments
The bleeding is from an injury to a vein or a branch of the posterior meningeal artery. The Minor Injury: Repair CSF
‣
most dangerous type of hematoma leak, lacerations of the
Subdural hematoma: Known as a subdural hemorrhage (SDH), is a type of hematoma, usually scalp
associated with traumatic brain injury. Blood gathers between the inner layer of the dura mater and ‣ Penetrating wounds: Surgical
the arachnoid mater. repair and antibiotics
Intracerebral Hematoma: Blood leaks into the brain as a result of head trauma or ‣ Moderate to severe head injury:
supportive care, prophylactic
spontaneously. Subarachnoid Hemorrhage: Bleeding into the subarachnoid space. Can be
antiseizure medications, prevent and
caused by ruptured aneurysm or trauma
control intracranial hypotension,
prevent brain damage from
hypotension , prevent anemia,
Increased arterial Carbon Dioxide
levels.
COMPLICATIO EDUCATION INTERVENTIONS ‣ Administer Glucocorticoids:
Dexamethasone, mannitol and
NS Educate the client and ‣ Monitor respiratory status and furosemide these are hypertonic
family on possible behavior maintain patent airway,
‣ Cerebral bleeding solutions that will pull fluid from the
increased C02 levels cause
‣ Hematoma changes, the long term cerebral edema. brain and decrease intracranial
‣ Uncontrollable ICP effects of a traumatic brain ‣ Monitor vitals & pressure.
‣ Infections injury and when to contact Temperature Monitor neuro
status ‣ Barbiturate therapy: Decreases cerebral
‣ Seizures
the HCP ‣ Monitor for signs of ICP metabolic weight.
‣ CSF leakage
‣ Mental status changes ‣ Keep head elevated to reduce ‣ Morphine Sulfate: Decreases agitation
venous pressure
‣ Behavioral changes and restlessness, administer with
‣ Prevent neck flexion
‣ Cranial nerve deficits caution because it can cause respiratory
‣ Initiate normothermia measures.
‣ Assess for pain and restlessness. depression which will also cause ICP.
‣ Monitor for CSF drainage
1
about:blan 1/
k 2
