Intracranial Regulation

What are the most common causes of TBIs? (SATA)

• MVA

• Contact sports such as football

• A minior fall

• Shaken Baby Syndrome

A patient has developed Chronic Traumatic Encephalopathy (CTE) . What would you expect to see in this patient?

• A history of multiply TBIs

• Early dementia

• acute signs and symptoms

• will have a progressive disease/ chronic condition

Answer explanation

Not everyone who has multiply TBIs develops CTE

A patient has arrived to the hostipal with a external scalp laceration, What is your pirorty intervention?

• Assess the patients carinal nervers

• Stop the bleeding

• Check PERRLA

• Assess LOC

Answer explanation

The scalp is highly vascualr- profuse bleeding

A patient sustained a diffuse axonal injury from a traumatic brain injury. What would the nurse explain to the family is the reason enteral nutrition is being started?

• Free water should be avoided.

• Sodium restrictions can be managed.

• Dehydration can be better avoided with feedings.

• Malnutrition promotes continued cerebral edema.

Answer explanation

A patient with diffuse axonal injury is unconscious and, with increased intracranial pressure, is in a hypermetabolic, hypercatabolic state that increases the need for energy to heal. Nutrition replacement should meet caloric needs by at least day 5 after injury. Malnutrition promotes continued cerebral edema. Fluid and electrolytes will be monitored to maintain balance with the enteral nutrition. Excess intravenous fluid administration will also increase cerebral edema

A patient with suspected bacterial meningitis just had a lumbar puncture in which cerebrospinal fluid was obtained for culture. Which medication would the nurse give first?

• Codeine

• Phenytoin

• Ceftriaxone

• Acetaminophen

Answer explanation

Bacterial meningitis is a medical emergency. When meningitis is suspected, antibiotic therapy (e.g., ceftriaxone) is started immediately after the collection of specimens for cultures and even before the diagnosis is confirmed. Dexamethasone may be given before or with the first dose of antibiotics. The nurse should collaborate with the health care provider to manage the headache (with codeine), fever (with acetaminophen), and seizures (with phenytoin)

What manifestations are associated with basilar skull fractures? (SATA)

• Battles Signs

• Periorbital brusing

• Cranial nerve deficits

Why is CSF leackage very dangerous?

• The blood brain barrier is broken, so toxins can get to the brain causing infection and inflamation that can not be treated by antibiotics.

• There is no problems with CSF leackage

• A decrease in blood pressure

Match the following

• Thalamus

• the dominant frontal lobe (which controls voluntary motor function) is responsible for the ability to express language

• Basal Ganglia

• mediated learning, emotional response, and automatic movements associated with skeletal muscle

• Wernicke's area

• The relay center for sensory input

• Broca's area

• the dominant temporal lobe (which controls hearing) and is responsible for compresion of spoken and written language

An elevated BP is common immeditely after a stroke. It reflects the body's attempt to maintain cerebral perfusion. The goal is to keep SBP <220; DBP <120

• Ture

• False

What interventions can you do to manage ICP to improve venous drainage?

• HOB at 30 degrees, keep the body midline, a low stimulation enivernoment, Ensure regular body temperture.

• HOB flat, keep the body right side-lying, T.V. on high volume,

• HOB at 90 degress, keep the prone, a high stimulation enivernoment, Ensure regular body temperture.

• HOB elevated, neutral body position, a low stimulation enivernoment, keep the room cold