TBI
The three manifestations of Cushing's triad.
What are severe hypertension, widened pulse pressure, and bradycardia?
Expected findings for meningitis.
What are decreased LOC, photophobia, nuchal rigidity, memory changes, nausea, vomiting, fever and chills?
Initial and priority assessment focuses in a patient with a cervical spinal cord injury.
What is airway management?
Expected findings for ALS.
What are fatigue, muscle atrophy and weakness, dysarthria, dysphagia, stiff and clumsy gait?
The most important variable to assess with any patient with a brain injury.
What is LOC?
"A decrease or change in LOC is typically the first sign of deterioration in neurologic status- restlessness, increased sleepiness, or combativeness"
Priority interventions for meningitis
Vitals and neuro checks every 2 to 4 hours to identify signs of increasing ICP and maintaining a patent airway?
Symptoms of neurogenic shock after a spinal cord injury.
What are bradycardia, hypotension and hypothermia?
A systolic BP less than 90mmHg requires treatment because lack perfusion to the spinal cord could worsen the patient's condition.
True or False: Once the ALS patient experiences difficulty breathing, supportive care should begin because the patient will not get better.
What is true?
"Progressive muscle weakness and wasting leading to paralysis of respiratory muscles."
Best position for a patient with a TBI.
What is HOB 30 degrees, avoiding extreme flexion or extension of the neck and maintaining the head in midline position? Also log roll the patient, to avoid extreme hip flexion.
Type of isolation a patient with bacterial meningitis should be on
What is Droplet Precautions?
Symptoms of autonomic dysreflexia
What are sudden, significant rise in BP, profuse sweating, flushing, goose bumps, and blurred vision?
Expected findings for Guillan Barre Syndrome (GBS).
Ascending symmetrical muscle weakness (flaccid paralysis without muscle atrophy), decreased DTRs, respiratory compromise, ataxia, paresthesia, pain (cramping), dysphagia, diplopia, difficulty speaking, CSF that reveals elevated protein?
Expected findings for a mild TBI.
What are disorientation, loss of short-term memory, dizziness, headache, and irritability?
Diagnostic tool for meningitis
What is a lumbar puncture and evaluation of cerebrospinal fluid?
Emergency interventions for Autonomic Dysreflexia (AD).
What are raise the HOB immediately, notify PCP and RRT, determine cause and treat promptly?
Treatment for GBS.
What are plasmapheresis and or IV immunoglobulin (IVIG)?
Corticosteroids are not used unless medically necessary to treat other associated diseases.
Monitor respiratory status closely and prepare to initiate respiratory support, monitor cardiac status, assess for complications of immobility.
Education for those experiencing a mild TBI.
What are avoid sedatives, do not engage in strenuous activity for 48 hours, give Tylenol for a headache?
Area where meningitis outbreaks are most likely to occur.
What are areas of high population density such as college dormitories, military barracks and crowded?
Medications used to treat hypotension and bradycardia when in neurogenic shock.
What are dopamine (vasopressor) and dextran (volume expander) and atropine (bradycardia)?
True or false: IVIG has been shown to be most effective when given as a bolus.
What is false?
Anaphylaxis can occur so IVIG initially infuses slowly and then the rate is increased based on how the patient tolerates the medication.