Term
| What is the range of scores on the Glasgow Coma Scale? |
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Definition
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Term
| a score between what two numbers indicates severe injury, on the GCS? |
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Definition
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Term
| a score between what two numbers indicates moderate injury, on the GCS? |
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Definition
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Term
| a score between what two numbers indicates mild injury, on the GCS? |
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Definition
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Term
| What CN will you likely see a defect in w/ increased ICP? |
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Definition
| 3 (efferent pupillary reactions) |
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Term
| What is physiological anisocoria? |
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Definition
| slightly different size of pupils |
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Term
| What are the surgical management techniques for TBI? |
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Definition
| Relief of brain compression (remove fragments), prevention of infection (antibiotics, removal of foreign bodies), Insertion of a device to monitor ICP. |
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Term
| What's the most common post-TBI surgical intervention? |
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Definition
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Term
| ICP is considered elevated under what conditions? |
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Definition
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Term
| What is Cerebral Perfusion Pressure? |
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Definition
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Term
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Definition
| Gives a more accurate picture of brain perfusion. MAP needs to be > ICP. If ICP is > MAP, blood can't perfuse brain tissue. |
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Term
| What is a normal cerebral perfusion pressure? |
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Definition
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Term
| How can CPP be raised? (3) |
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Definition
| 1. osmotic therapy to lower ICP, 2. sedative therapy to reduce CBF, cerebral metabolic rate and thus ICP, 3. Vasopressive drugs to elevate MAP. |
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Term
| What are the 10 general and metabolic management issues for a TBI pt? |
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Definition
| 1. catheter to monitor I & O accurately. 2. Maintainance of normal electrolyte balance. 3. Bowel Care. 4. skin care 5. respiratory care. 6. ROM 7. positioning for coma pt 8. Corneal protection for comatose pt w/ eyes open. 9. NG tube 10. Watch for fever. |
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Term
| Watching for a fever has two major implications. What are they? |
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Definition
| 1. Fever can = infection. 2. Control of temp helps control ICP. (Incr temp is associated w/ incr ICP.) |
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Term
| What are the GI complications seen in TBI pts? |
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Definition
| stress ulcers and liver dysfunction |
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Term
| why is liver dysfunction seen in TBI pts? |
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Definition
| cardiac shock and decr blood supply to the liver -> liver dysfunction |
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Term
| Cardiac dysfunction may be seen in the TBI pt. Why? |
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Definition
| Electrolyte imbalances, and changes in ventilation can result in cardiac complications. |
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Term
| what are the two types of 'neurogenic bladder'? What nerves affect bladder function? |
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Definition
| spastic and flaccid. nerves S2-4. |
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Term
| Spactic neurogenic bladder affects function how? |
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Definition
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Term
| what is overflow incontinence? |
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Definition
| flaccid neurogenic bladder results in a non-emptying bladder. |
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Term
| What are they hyponatremia Sx? (7) |
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Definition
| Mental status changes, lethargy, coma, psychosis, seizures, cramps, nausia. |
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Term
| what are some causes of hyponatremia? (8) |
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Definition
| osmotic diuresis, kidney failure, vomiting, diarrhea, water intoxication, hypothyroidism, heart failure, meds. |
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Term
| What are the Sx of hypernatremia? (3) |
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Definition
| severe thirst, lethargy, coma |
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Term
| what are causes of hypernatremia? (4) |
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Definition
| diabetes, meds, impaired thirst, Na overload |
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Term
| What are some causes of peripheral nerve injuries? (4) |
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Definition
| trauma, poor positioning, post-op complications, heterotropic ossification |
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Term
| where is heterotopic ossification commonly seen? (3) |
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Definition
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Term
| What are potential complications caused by HO? (5) |
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Definition
| ankylosis, pain and limited ROM, peripheral nerve compression, vascular compression, lymphedema. |
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Term
| What are the risk factors for HO? (3) |
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Definition
| prolonged coma, immobility, spasticity |
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Term
| how long after TBI is HO usually seen? |
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Definition
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Term
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Definition
| decr ROM, swelling, erythema, warmth, muscle guarding, fever. |
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Term
| What are the Tx options for HO? |
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Definition
| ROM exercises, control of muscle tone (to increase range, not decrease HO), NSAIDS (a little bit of research supports), prophylactic meds, surgical resection. |
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Term
| How common is post-traumatic epilepsy in TBI pts? |
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Definition
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