Medical Surgical Nursing

(Tina Sui) #1

Collaborative Problems/Potential Complications



  • Decreased cerebral perfusion

  • Cerebral edema and herniation

  • Impaired oxygenation and ventilation

  • Impaired fluid, electrolyte, and nutritional balance

  • Risk of posttraumatic seizures


Nursing Process: Planning


— Major goals may include


— Maintenance of patent airway,


— Adequate cerebral perfusion pressure (CPP),


— Fluid and electrolyte balance,


— Adequate nutritional status,


— Prevention of secondary injury,


— Maintenance of normal temperature,


— Maintenance of skin integrity,


— Improvement of cognitive function,


— Prevention of sleep deprivation,


— Effective family coping,


— Increased knowledge about rehabilitation process, and


Nursing Process: Interventions



  • Ongoing assessment and monitoring is vital

  • Maintenance of airway

    • Positioning to facilitate drainage of oral secretions with HOB usually elevated
      30° to decrease venous pressure

    • Suctioning with caution

    • Prevention of aspiration and respiratory insufficiency

    • Monitor ABGs, ventilation, and mechanical ventilation

    • Monitor for pulmonary complications, potential



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