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Traumatic Brain Injury in children
CSM Pediatrics Traumatic Brain Injury
24
Nursing
Undergraduate 3
03/12/2016

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Cards

Term
What is a concussion?
Definition
Immediate transient loss of brain function at the brain stem due to trauma
Term
What are characteristics of a concussion?
Definition
Loss of consciousness, cannot remember before and after, confused & lethargic, vomiting, 24-48 hours later symptoms gone, headaches up to six months after
Term
What are the types of closed head injuries?
Definition
skull fractures
Term
What is a contusion of the brain?
Definition
Small hemorrhage from a tear or laceration of the brain; can cause seizures or hemiplegia
Term
What is the coup/contracoup?
Definition
Coup- impact
Contracoup- brain smashing skull
Term
What are the kinds of skull fractures?
Definition
1. Depressed fracture- fragment of bone in the brain
2. Basilar skull fracture
3. Linear fracture
4. Compound fracture
Term
What are complications of a subdural hematoma?
Definition
Venous bleeding between the dura and the brain that causes ICP to rise and pushes the brain on the other side of the tentorial plate pushing on the lower brain functions. The brain then begins to push through the foramen magnum. Secondly, as it tries to resolve the RBCs try to breakdown the clot and absorb fluid causing an increase in ICP. Can also be a sign of abuse.
Term
What are complications with an epidural hematoma?
Definition
An epidural hematoma occurs on the outside of the dura where arteries are torn. Worse than a subdural hematoma.
Term
What is an acute subdural hematoma?
Definition
Symptoms within 24 hours
Term
What is a gradual subdural hematoma?
Definition
Symptoms get worse over weeks due to the clots breaking down causing a rise in ICP. Babies from 2-6 months can have gradual subdural hematomas from birth
Term
What are symptoms of subdural hematomas?
Definition
Anemia
Seizures
vomiting
bulging fontanelles
Headaches
Lethargy
Unsteady gait
Term
What diagnostic tool can show bleeding?
Definition
CT scan
Term
What are assessment findings that could indicate mild brain injury?
Definition
1. No loss (or brief loss) of consciousness
2. Mild headache that will not go away with medications
3. Memory problems
4. Fatigue & irritability
5. Change in appetite
6. Changes in school performance
7. Sensitivity to lights and sounds
Term
What are assessment findings that could indicate moderate brain injury?
Definition
1. Glassgow 9 to 12
2. Loss of consciousness
3. Headache
4. Nausea & vomiting
5. Amnesia for 1 to 24 hours
Term
What are assessment findings that could indicate severe brain injury?
Definition
1. Glassgow less than 8
2. Amnesia for more than 24 hours
3. Signs of increased ICP
4. Prolonged period of unconsciousness
Term
How do you manage mild brain injury?
Definition
1. monitor LOC
2. Watch for signs of rising ICP
3. Restriction on activities
4. may take up to 6 weeks for full recovery
Term
How do you manage severe brain injury?
Definition
1. Airway, breathing & circulation; Hyperventilation (constricts blood vessels
2. Assess Neuro status
3. Extra-ventricular drainage device
4. Elevate head of bed to 30 degrees if there is no neck injury
5. Keep head midline
6. Monitor vital signs, intake & output, and ICP (cushing's triad)
7. Skin care & ROM
Term
What is Cushing's triad?
Definition
1. Increasing systolic BP
2. Decreasing Pulse
3. Altered respirations
Term
What drugs are given for severe brain injuries?
Definition
1. Diuretics (furosemide, mannitol)
2. Ophthalmic lubricants to protect the cornea (coma patients)
3. Stool softeners
4. Sedatives, if paralytics are needed (ventilation)
5. Decadron
Term
What are considerations for using mannitol & what does it do?
Definition
Diuretic that decreases ICP, fast acting, cannot be given more than 3 times in 24 hours
Term
What are when using Decadron & what does it do?
Definition
Steroid that decreases ICP but takes 12 hours to work, it is 10x more powerful than prednisone, always check for blood sugars/diabetes prior to administration
Term
What is the normal ICP?
Definition
normal ICP is 10-15 mm hg
Term
What type of monitors are used for ICP?
Definition
Extra-ventricular drainage device
Term
What are complications of traumatic brain injury?
Definition
Brain herniation, Learning disaabilities, Seizures, Hydrocephalus
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