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36 Head Injury STUDENT REVIEW SHEET Matching Exercises a. Coup b. Cerebral contusion c. Subdural hematoma d. Dysphasia e. Dysarthria f. Neurogenic pulmonary edema 1.___ A complication of many brain-injured patients that involves difficulty using or understanding language as a result of their injury 2.___ A classification of brain injury in which most of the damage occurs relatively close to the impact site 3.___ A frequently seen brain lesion in which an area of the brain is bruised without being punctured or lacerated 4.___ The tearing of surface veins or dislodgement of pools of venous blood causing accumulation of blood below the dural meningeal layer and above the arachnoid covering of the brain 5.___ A complication resulting from the sympathetic nervous system response to increasing intracranial pressure (ICP), leading to vasoconstriction and causing more blood to be shunted to the lungs 6.___ A group of speech disorders resulting from disturbances in muscular control of the speech mechanism as a result of damage to the central or peripheral nervous systems True/False Questions 1.___ The majority of head injuries are caused by motor vehicle crashes, followed by falls and assaults. 2.___ Linear skull fractures may be limited to the floor of the skull or may occur in association with fractures of the cranial vault, such as parts of the frontal or temporal bones. 3.___ Large cerebral contusions may expand over 2 to 3 days after the injury and may create widespread dysfunctions as a result of increasing cerebral edema. 4.___ Numerous locations in both cerebral hemispheres regulate voluntary control over the muscles used in breathing, with the cerebellum synchronizing and coordinating the muscular effort. 5.___ Clinical manifestations of diabetes insipidus are decreased urine output, urine specific gravity usually greater than 1.025, hemodilution as evidenced by decreased hematocrit, and hyponatremia. 6.___ For patients receiving phenytoin, the nurse should pay careful attention to the patient’s cardiac rate and rhythm. 7.___ Suctioning through the nasopharynx should be avoided in a patient with suspected basilar skull fracture. Short Answer/Fill-in Questions 1. List three severity-of-head-injury classifications and the description of deficit according to the Glasgow Coma Scale. a. b. c. 2. Identify three nursing strategies to assist the patient with sensory stimulation after head injury. a. b. c. 3. Name three types of breathing patterns and the neuroanatomical lesion involved. a. b. c. Essay Question Describe Cushing’s triad and its value in the determination of increased ICP.
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