Avoidables
What position can a client with TBI rest in?
What is avoid prone of HOB < 30 degrees? No hip, neck, knee flexion.
A penlight is used to perform this test
Needle placed into SA space at L3-4 in order to aspirate CSF.
What is lumbar puncture?
Characterized by vasospasm of cerebral arteries
What is Subarachnoid hemorrhage?
Gold standard for measuring ICP. Good for instilling dye and antibiotics and aspirating CSF.
What is ventriculostomy?
Advise a client with basilar skull fracture to
What is avoid nasal suctioning, packing, or nasogastric tube?
A perfect score is 15.
What is Glasgow Coma Scale?
Measure taken prior to suctioning
What is hyperoxygenation?
Characterized by altered LOC, a period of brief lucidity, followed by altered LOC
What is epidural hematoma?
Name 3 general early signs of IICP.
What is changes in LOC, papilledema, HTN, headache, tachyarrhythmias, vomiting, blurred vision?
A client is concerned about taking stool softeners as they don't want to become dependent. What is your best response?
What is to avoid Valsalva?
Involves rotating the client's head and watching for eye movement
What is oculocephalic reflex? (Doll's eyes)
Provide good oral hygiene without doing this?
What is stimulating the gag reflex?
Characterized by time of onset after injury
What is subdural hematoma?
Name three late signs of IICP.
What is posturing, positive Babinski reflex, Cushing's triad, coma?
Family education r/t environment of brain injured clients includes:
What is avoid temperature extremes, loud noises, bright light?
Client flexes arms up onto chest and plantar flexion of legs is noted.
What is decorticate posturing?
Recommendations for pulmonologist for vent settings should include...
What is decreased or no PEEP?
Primary injury of white matter with poor prognosis
What is diffuse axonal injury?
Conditions that cause cerebral vasodilation and increased ICP
MAP <
What is 60?
What is Cushing's Triad?
What is eye care, oral care, VTE and GI prophylaxis, talk to client, nutrition?
Direct damage from impact as well as opposite side damage from shearing, ripping, and bouncing
What is coup contre coup injury?
What is the term used for arching of the back commonly associated with decerebrate posturing?
What is Opisthotonis?