Brain Basics
What is an early sign of increased intercranial pressure in cerebral edema?
Confusion or change of LOC
Which stroke type is caused by bleeding into the brain tissue?
Hemorrhagic stroke
What immediate nursing intervention is essential when a spinal cord injury patient arrives to maintain safety?
Maintain Spinal Alignment
What signs or symptoms indicate a concussion is worsening
Vomiting, LOC changes, Pupillary changes, posturing, Cushing's triad
Why are corticosteroids used in some cases of brain swelling?
They reduce inflammation and vasogenic edema (especially tumor-related).
What does hypertension with wide pulse pressure, Bradycardia, and irregular respirations represent?
Cushing's triad
What diagnostic test MUST be done before giving any thrombolytic medication?
CT scan to check for bleeding
Why is a bowel program critical in spinal cord injury patients?
To prevent autonomic dysreflexia
A Glascow score of what is concerning for severe brain injury
8 or less
What assessment finding shows mannitol is working?
Increased urine output and improved LOC
How does low serum sodium worsen cerebral edema?
Water moves into brain cells, causing swelling (cellular edema)
What does BEFAST stand for
Balance
Eyes
Face
Arm
Speech
Time
Injury at C4 affects what critical function
Breathing — may require ventilatory support.
Clear fluid leaking from a patient’s nose or ear after head injury likely indicates what?
CSF leak
What medication should be avoided when a patient is taking antiplatelet medication?
NSaids- They increase bleeding risk
what position should the bed be kept for a patient with increased intercranial pressue?
HOB 30 degrees or more
Before giving food or fluids to a stroke patient, what must be completed and why?
Swallow evaluation to prevent aspiration
A resident with a T6 spinal cord injury develops severe hypertension, headache, and flushing. What is this condition?
Autonomic Dysreflexia
What type of head injury occurs when the brain strikes the inside of the skull on the same side as the impact.
Coup injury
What time window determines whether or not TPA should be given
3-4.5 hours
According to the Monro–Kellie doctrine, what three components determine intracranial pressure?
Brain tissue, blood, and cerebrospinal fluid (CSF)
What are the risk factors for stroke
High blood pressure, high cholesterol, smoking, diabetes
What is the priority action when a patient with a T6 injury has severe hypertension and a pounding headache?
Sit them upright and remove triggers (check bladder/bowel).
Agitation, restlessness, or sudden irritability after a head injury may indicate this dangerous complication
Increasing ICP
What class of medications should be avoided in TBI patients
opiods- can mask changes in neurological status