RNSG 2539 EXAM 3 Cognition

RNSG 2539 EXAM 3 – Cognition Questions with complete Solutions 100% Verified Graded A+ Most common times that deaths occur after a head injury - Correct Answer 1. Immediately After

• Within 2 hours
• Within 3 weeks

Complications with scalp lacerations - Correct Answer - Profuse Bleeding

• Infection

Many blood vessels in the scalp. Even a small cut can cause much bleeding Manifestations of frontal fracture - Correct Answer air in forehead tissue CSF rhinorrhea, pneumocranium (air between cranium and dura mater) Manifestations of Orbital Fracture - Correct Answer Periorbital ecchymosis (raccoon eyes) optic nerve injury Manifestations of Temporal Fracture - Correct Answer oval-shaped bruise behind ear in mastoid region (Battle's sign) CSF otorrhea middle meningeal artery disruption epidural hematoma Manifestations of Parietal fracture - Correct Answer Deafness CSF or brain otorrhea bulging of tympanic membrane caused by blood or CSF 1 / 3

facial paralysis loss of taste Battle's sign Manifestations of Posterior fossa fracture - Correct Answer cortical blindness visual field defects rare appearance of ataxia or other cerebellar signs Manifestations of Basilar skull fracture - Correct Answer CSF or brain otorrhea bulging of tympanic membrane caused by blood or CSF Battle's sign tinnitus or hearing difficulty rhinorrhea facial paralysis conjugate deviation of gaze vertigo How to test fluids for CSF - Correct Answer 1. glucose test (unreliable if there is blood) - Dextrostix or Tes-Tape

• Halo sign

Nursing Interventions for Skull Fracture - Correct Answer *Basilar* Orgosastric tube NOT NGT

• IF GCS Less than 8....INTUBATE
• Determine CSF leakage
• Eye drops/ eye patch for diplopia 2 / 3

• Remove patient's clothing
• Keep patient warm
• Monitor for S&S of hyperthermia
• Monitor for Infection

Diffuse Brain Injury - Correct Answer Ex. Concussion

• Injury cannot be localized to one particular area
• Pt may or may not lose total consciousness
• If loss of LOC is <5 min then sent home with HCP instructions

*Postconcussion syndrome*

• Occurs within 2 weeks to 2 months
• Lethargy, HA, personality changes, decreased memory and intellectual ability

*Diffuse Axonal Injury (DAI)*

• Widespread axonal damage after TBI
• Takes 12-24 hours or longer to develop
• decreased LOC, increased ICP, decortication or decerebration, and global cerebral edema
• 90% of pts remain in persistant vegetative state

Focal Brain Injury - Correct Answer - Tissue damage is severe

• Surgical repair is impossible

*antibiotics (until meningitis ruled out* unconsciousness, *hemiplegia on the contralateral side* *a dilated pupil on the ipsilateral side*

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