Student Traumatic Brain Injury with Increased Intracranial Pressure 2018
Traumatic Brain Injury with Increased Intracranial Pressure
Patient Profile
D.G., a 19-year-old male, was brought to the emergency department following a motor
vehicle accident in
which he was the driver. He is transferred to the Neuro-Trauma Intensive Care Unit with a
diagnosis of traumatic brain injury.
Subjective Data
• Multiple family members and friends in the waiting room
• D.G.'s girlfriend died on scene
• Hospital chaplain present
Objective Data
Physical Examination
• Glasgow coma scale 4
• Neurologic Assessment:
o Pupils 4 mm and sluggish
o Decerebrate posturing
o Periorbital ecchymosis
• Clear drainage from nares is positive for glucose
Diagnostic Studies
• Computed tomography (CT) scan: Subdural hematoma compressing the
ipsilateral ventricle and causing a midline shift
Collaborative Care
• Admission orders include:
o Multiple line placements: Arterial monitoring, central venous
pressure line, ventriculostomy, and jugular bulb oximetry
o Keep cerebral perfusion pressure (CPP) > 70 mm Hg
o Begin standing orders for proprofol (Diprivan), midazolam (Versed),
ranitidine (Zantac), and phenytoin (Dilantin)
This study source was downloaded by 100000832558064 from CourseHero.com on 05-23-2022 01:54:33 GMT -05:00
https://www.coursehero.com/file/39945168/Student-Traumatic-Brain-Injury-with-Increased-Intracranial-Pressure-2018docx/
Traumatic Brain Injury with Increased Intracranial Pressure
Patient Profile
D.G., a 19-year-old male, was brought to the emergency department following a motor
vehicle accident in
which he was the driver. He is transferred to the Neuro-Trauma Intensive Care Unit with a
diagnosis of traumatic brain injury.
Subjective Data
• Multiple family members and friends in the waiting room
• D.G.'s girlfriend died on scene
• Hospital chaplain present
Objective Data
Physical Examination
• Glasgow coma scale 4
• Neurologic Assessment:
o Pupils 4 mm and sluggish
o Decerebrate posturing
o Periorbital ecchymosis
• Clear drainage from nares is positive for glucose
Diagnostic Studies
• Computed tomography (CT) scan: Subdural hematoma compressing the
ipsilateral ventricle and causing a midline shift
Collaborative Care
• Admission orders include:
o Multiple line placements: Arterial monitoring, central venous
pressure line, ventriculostomy, and jugular bulb oximetry
o Keep cerebral perfusion pressure (CPP) > 70 mm Hg
o Begin standing orders for proprofol (Diprivan), midazolam (Versed),
ranitidine (Zantac), and phenytoin (Dilantin)
This study source was downloaded by 100000832558064 from CourseHero.com on 05-23-2022 01:54:33 GMT -05:00
https://www.coursehero.com/file/39945168/Student-Traumatic-Brain-Injury-with-Increased-Intracranial-Pressure-2018docx/
