Medical Surgical Nursing

• Changes in vital signs


• Headache


• Seizures

Brain Injury

• Closed brain injury (blunt trauma): acceleration/deceleration injury occurs when the

head accelerates and then rapidly decelerates, damaging brain tissue

• Open brain injury: object penetrates the brain or trauma is so severe that the scalp and

skull are opened

• Concussion: a temporary loss of consciousness with no apparent structural damage


• Contusion: more severe injury with possible surface hemorrhage
  
  
  • Symptoms and recovery depend upon the amount of damage and associated
    cerebral edema
  
  
  • Longer period of unconsciousness with more symptoms of neurologic deficits and
    changes in vital signs
  
  
  
  


• Diffuse axonal injury: involves widespread damage to axons in the cerebral

hemispheres, corpus callosum, and brain stem. It can be seen with mild, moderate, or

severe head trauma. Patient develops immediate coma.

• Intracranial bleeding

1. Epidural hematoma

2. Subdural hematoma

3. Acute and subacute

4. Chronic

5. Intracerebral hemorrhage and hematoma

Concussion

• Patient may be admitted for observation or sent home


• Observation of patients after head trauma; report immediately
  
  
  • Observe for any changes in LOC
  
  
  • Difficulty in awakening, lethargy, dizziness, confusion, irritability, anxiety
  
  
  • Difficulty in speaking or movement
  
  
  • Severe headache
  
  
  • Vomiting