19 Quote from text“After the skull fragments are elevated, the area is debrided. Large defects can be repaired immediately with bone or artificial grafts; if significant cerebral edema is present, repair of the defect can be delayed for 3-6 months.”
20 Skull Injuries / Fractures Medical ManagementBasilar skull fracturesUsually open or closed?OPENKeep nose and earsCleanSterile cotton pad/ballLoosely insertedInstruct pt not toBlow noseHOB:UpI-ICP protocol
21 Question??????You notice the sheet under a patients head is red with blood, but the stain has a yellowish ring around it. What would be a priority nursing actions?Notify MDInfection control!!Act first -- document last
22 Question????How do you prevent infections in a patient with a head wound?CleanInject antibiotic
23 A patient enters the ER following a MVA where he was thrown from the car. He has a major head wound. His vital signs show very low blood pressure. What does this indicate?HypovolemiaMore than just head injury
24 Question????An open skull fracture means what? What nursing measures do you implement? What are the risks?Dura mater is tornCSF leakage possibleIncrease risk of infection
25 Question?????What kind of an injury produces hemorrhaging from the nose, pharynx and ears?Basil skull fracture
26 Question????Do you give morphine for pain to a patient with head injury? Why or why not?NOInterferes with accurate neuro assessment
27 Brain Injury Concussion Pathophysiology Closed / open? Temporary loss of neurologic function with no apparentStructural damageClosed / open?ClosedDuration of unconsciousness?Seconds to few minutes
67 SCI: Complications & Interventions Thermal Regulation Not perspireFever?
68 SCI: Complications & Interventions Autonomic Hyperflexia /dysreflexia Injury impairs normal equilibrium between the sympathetic and parasympathetic systemVasoconstriction below the level of injuryVasodilation above the level of injuryCommon causeNoxious StimuliBelow level of injury
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