Neurological Trauma Flashcards

A patient with a TBI is ordered 3% hypertonic saline. What is the primary goal of this therapy?

Answer: Reduce cerebral edema and lower intracranial pressure by creating an osmotic gradient

Hypertonic saline draws free water out of brain tissue via osmosis, reducing cerebral edema and lowering ICP.

Which position is recommended for patients with TBI to minimize ICP elevation?

Answer: Head of bed elevated 30 degrees with head midline

HOB 30° with neutral head alignment promotes cerebral venous drainage without compromising cerebral perfusion pressure.

When assessing pupils in a TBI patient, which finding indicates the most critical concern?

Answer: One fixed, dilated pupil on the side of a known hematoma

Ipsilateral fixed, dilated pupil indicates uncal herniation with CN III compression, a neurosurgical emergency.

A trauma patient is noted to have cerebrospinal fluid (CSF) draining from the ear. The nurse should:

Answer: Place a loose sterile dressing to collect fluid and notify the provider; do not pack the ear

CSF otorrhea must not be obstructed; the ear should be loosely covered and the provider notified to prevent meningitis risk.

Which statement about pediatric head trauma and TBI is correct?

Answer: Children have a larger head-to-body ratio than adults, making them more susceptible to acceleration-deceleration injuries

Children's disproportionately large heads make them more vulnerable to rotational and acceleration-deceleration forces.

Post-traumatic seizures in TBI patients are classified as immediate (within 24 hours), early (1–7 days), or late (>7 days). Which type is associated with the highest risk of developing epilepsy?

Answer: Late seizures

Late post-traumatic seizures, occurring more than 7 days after injury, indicate permanent epileptogenic changes and are strongly associated with ongoing epilepsy.