NURS MISCClosed Head Injury CASE STUDY
Closed Head Injury Case Study
Scenario
Y.W. is a 23-year-old male student from Thailand studying electrical engineering at
the university. He was ejected from a moving vehicle, which was traveling 70 mph.
His injuries included a severe closed head injury with an occipital hematoma,
bilateral wrist fractures, and a right pneumothorax. During his neurologic intensive
care unit (NICU) stay, Y.W. was intubated and placed on mechanical ventilation, had
a feeding tube inserted and was placed on tube feedings, had a Foley catheter to
down drain
(DD), and had multiple IVs inserted. He developed pneumonia 1 month after
admission.
1. Define the term primary head injury.
Primary head injury means tissue damage resulting from the traumatic impact and
can include the scalp, skull, or brain tissue itself.
2. Define the term secondary head injury.
Secondary head injury is an event that complicates the primary head injury and
causes further damage resulting in a worse outcome and increased risk of death.
They include intracranial hemorrhage, cerebral edema, increased ICP, ischemic
brain injury and infection.
3. What is normal intracranial pressure (ICP), and why is increased ICP so
clinically important?
Normal ICP is 10-15 mm Hg. A sustained increased ICP of greater than 15 mm HG
means decreased blood flow to the brain tissue and decreased O2 delivery. If
sustained it can lead to brain anoxia, atrophy, herniation, and death.
4. Identify at least five signs and symptoms (S/S) of increased ICP.
▪ altered or decreased LOC
▪ worsening headache
▪ blurred vision
▪ weakness or sensory motor changes
▪ N/V
▪ widened pulse pressure
▪ bradycardia
5. List 4 medication classifications that the ICU nurses could use to
decrease or control increased ICP.
▪ Osmotic diuretic (Mannitol)
▪ Loop diuretic
▪ Antipyretics
▪ Benzodiazepines
▪ Neuromuscular blockers
▪ Propofol or Versed
▪ Lidocaine
This study source was downloaded by 100000832558064 from CourseHero.com on 05-23-2022 02:13:57 GMT -05:00
https://www.coursehero.com/file/23129529/Closed-Head-Injury-CASE-STUDY/
Closed Head Injury Case Study
Scenario
Y.W. is a 23-year-old male student from Thailand studying electrical engineering at
the university. He was ejected from a moving vehicle, which was traveling 70 mph.
His injuries included a severe closed head injury with an occipital hematoma,
bilateral wrist fractures, and a right pneumothorax. During his neurologic intensive
care unit (NICU) stay, Y.W. was intubated and placed on mechanical ventilation, had
a feeding tube inserted and was placed on tube feedings, had a Foley catheter to
down drain
(DD), and had multiple IVs inserted. He developed pneumonia 1 month after
admission.
1. Define the term primary head injury.
Primary head injury means tissue damage resulting from the traumatic impact and
can include the scalp, skull, or brain tissue itself.
2. Define the term secondary head injury.
Secondary head injury is an event that complicates the primary head injury and
causes further damage resulting in a worse outcome and increased risk of death.
They include intracranial hemorrhage, cerebral edema, increased ICP, ischemic
brain injury and infection.
3. What is normal intracranial pressure (ICP), and why is increased ICP so
clinically important?
Normal ICP is 10-15 mm Hg. A sustained increased ICP of greater than 15 mm HG
means decreased blood flow to the brain tissue and decreased O2 delivery. If
sustained it can lead to brain anoxia, atrophy, herniation, and death.
4. Identify at least five signs and symptoms (S/S) of increased ICP.
▪ altered or decreased LOC
▪ worsening headache
▪ blurred vision
▪ weakness or sensory motor changes
▪ N/V
▪ widened pulse pressure
▪ bradycardia
5. List 4 medication classifications that the ICU nurses could use to
decrease or control increased ICP.
▪ Osmotic diuretic (Mannitol)
▪ Loop diuretic
▪ Antipyretics
▪ Benzodiazepines
▪ Neuromuscular blockers
▪ Propofol or Versed
▪ Lidocaine
This study source was downloaded by 100000832558064 from CourseHero.com on 05-23-2022 02:13:57 GMT -05:00
https://www.coursehero.com/file/23129529/Closed-Head-Injury-CASE-STUDY/
