Traumatic Brain Injury and Spinal Cord Injury Flashcards

Which classification of traumatic brain injury (TBI) is defined by a GCS score of 13–15?

Answer: Mild TBI

Mild TBI is defined by a GCS of 13–15, moderate TBI by GCS 9–12, and severe TBI by GCS 8 or below.

A patient with a basilar skull fracture may exhibit which classic clinical sign involving discoloration around the eyes?

Answer: Raccoon eyes (periorbital ecchymosis)

Raccoon eyes (bilateral periorbital ecchymosis) indicate a basilar skull fracture involving the anterior cranial fossa.

Which type of intracranial hematoma is caused by arterial bleeding, typically from rupture of the middle meningeal artery, and presents with a lucid interval?

Answer: Epidural hematoma

Epidural hematoma results from arterial (middle meningeal artery) bleeding, often showing a classic lucid interval before rapid neurological deterioration.

For severe TBI management, the Brain Trauma Foundation recommends maintaining ICP below:

Answer: 22 mmHg

The Brain Trauma Foundation guidelines recommend treating ICP when it exceeds 22 mmHg to reduce mortality in severe TBI.

The nurse is caring for a patient with severe TBI receiving hypertonic saline for ICP management. The MOST important parameter to monitor is:

Answer: Serum sodium and osmolality

Hypertonic saline can cause hypernatremia and hyperosmolality; serum sodium and osmolality must be monitored to prevent complications.

Which clinical finding differentiates neurogenic shock from spinal shock after acute spinal cord injury?

Answer: Hypotension with bradycardia (neurogenic) vs. flaccid areflexia below injury (spinal shock)

Neurogenic shock refers to hemodynamic instability (hypotension and bradycardia) from loss of sympathetic tone, while spinal shock is the physiologic state of flaccid areflexia below the injury level.