Case Study Acute Head Injury<\/p>\n
J.R. is a 28-year-old man who was doing home repairs. He fell from the top of a 6-foot stepladder, striking his head on a large rock. He experienced a momentary loss of consciousness. By the time his neighbor got to him, he was conscious but bleeding profusely from a laceration over the right temporal area. the neighbor drove him to the emergency department of your hospital. As the nurse, you immediately apply a cervical collar, lay him on a stretcher, and take J.R. to a treatment room.<\/p>\n
1.\tWhat steps will you take to assess J.R.?<\/p>\n
2.\tList at least five components of a neurologic examination.<\/p>\n
3.\tWhat types of injuries may J.R. have sustained?<\/p>\n
4.\tWhat complication common to each of these diagnoses concerns you most?<\/p>\n
5.\tIdentify at least six findings that would indicate this complication is occurring.<\/p>\n
6.\tWhat is the most sensitive indicator of neurologic change?<\/p>\n
Case Study Progress
\nYou complete your neurologic examination and find the following: Glasgow Coma Scale (GCS) score of 15; pupils equal, round, reactive to light; and full sensation intact. J.R. complains of a headache and is somewhat drowsy. His vital signs (VS) are 120\/72, 114, 30, 98.7 \u00b0 F (37.1 \u00b0 C) and SpO2 94%. As the radiology technician performs a portable cross-table lateral cervical spine x-ray examination, J.R. begins to speak incoherently and appears to drift off to sleep.<\/p>\n
7.\tWhat are the next actions you will take?<\/p>\n
Case Study Progress
\nWhile waiting for the physician to arrive, you find that J.R. has become unresponsive to verbal stimuli. the right pupil is larger than the left and does not respond to light. J.R. responds to painful stimuli in the manner shown in the illustration.<\/p>\n
8.\tWhat is this response called and what does it signify?<\/p>\n
9.\tCalculate J.R.’s GCS score. Describe the clinical implications of this score.<\/p>\n
10.\tWhat is the likely cause of the change in J.R.’s neurologic status?<\/p>\n
11.\tWhat are your nursing priorities at this time?<\/p>\n
12.\tWhat immediate actions will you take?<\/p>\n
13.\tHis vital signs are now 160\/72, 64, 10, 98.7 \u00b0 F (37.1 \u00b0 C), and Spo2 94%. What is your concern and why?<\/p>\n
Case Study Progress
\nthe physician arrives and gives the orders shown in the chart.<\/p>\n
14.\tOutline a plan for implementing these orders.<\/p>\n
15.\tWhat is Mannitol, and why is it being administered to J.R.?<\/p>\n
16.\tWhat is the expected outcome associated with administering phenytoin to J.R.?<\/p>\n
Case Study Progress
\nJ.R. is transported to radiology for a Ct scan; he is found to have a large epidural hematoma on the right with a hemispheric shift to the left. He is taken straight to the operating room for evacuation of the hematoma. While he is in surgery, J.R.’s family arrives with their faith healer. they ask that their faith healer anoint J.R. and pray over him.<\/p>\n
17.\tHow should you respond?<\/p>\n
Case Study Progress
\nPostoperatively J.R. is admitted to the neurologic ICU.<\/p>\n
18.\tWhat assessment indicators will be closely monitored in J.R.?<\/p>\n
19.\tIdentify eight independent nursing interventions and the rationale for each that would be used to prevent increased intracranial pressure (ICP) in the first 48 postoperative hours.<\/p>\n","protected":false},"excerpt":{"rendered":"
Case Study Acute Head Injury J.R. is a 28-year-old man who was doing home repairs. He fell from the top of a 6-foot stepladder, striking\u2026<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[479,537,172,478,6744],"tags":[7780,7779,687,7783,3504,8899,8900,7782,7785,7787,7784,7781,8901,7788,7786],"class_list":["post-95722","post","type-post","status-publish","format-standard","hentry","category-nursing-course-hero","category-nursing-essay-pro","category-nursing-study-bay","category-nursing-study-pool","category-nursing-studybay","tag-apps-to-help-with-writing-assignment","tag-assignment-help-in-australia","tag-assignment-help-website","tag-assignment-helpers-for-students","tag-essay-writing","tag-essy-help","tag-essy-pro","tag-help-students-with-assignment","tag-i-will-pay-someone-to-do-my-assignments","tag-looking-for-someone-to-do-my-assignments","tag-pay-someone-to-do-my-assignment","tag-paying-someone-to-do-assignment","tag-studbay","tag-studybay","tag-university-assignment-hacks"],"_links":{"self":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/95722","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/comments?post=95722"}],"version-history":[{"count":0,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/posts\/95722\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/media?parent=95722"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/categories?post=95722"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.studyproessays.com\/help\/wp-json\/wp\/v2\/tags?post=95722"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}