NURSING CARE

Nursing Concerns



Nursing Concerns

This paper focuses on the immediate nursing care for a Traumatic Brain injurycase according to the scenario the presented in the article “Snowboarder Suffers Traumatic Brain injury” published in the LA Times that reported on the progress of Kevin Pearce who was injured while training for the Olympics.

1. Immediate care:

a. What Would Be The Critical Priorties To Be Considered?

The recent death of Kevin Pearce shows that even those with the mildest of symptoms should seek emergency care following trauma to the head. While those who are unconscious or who are experiencing severe symptoms will likely be immediately transported to the nearest facility qualified to handle brain injury, it's up to those with less severe symptoms—symptoms such as dilated pupils, nausea, dizziness, lethargy, vomiting, and confusion—to make a judgment call on their own. As a general rule of thumb, if any of these symptoms are present medical care should be immediately sought. Those who are treated in a timely manner have a better long-term prognosis in general. What kinds of care can be expected immediately following a brain injury, during what is commonly called the “acute care phase?” That will depend upon the condition of the patient and the severity of the injury. Patients with very severe brain injuries may require life support, while those with minimal injuries may be sent home to recover with little more than instructions to take it easy for several weeks. In general, the first action the medical team will take will be to ensure that the patient is stable. Any life-threatening injuries will be attended to, and respiration and circulation will be monitored. At this point physicians will attempt to control or minimize intracranial pressure, as excessive swelling can cause further brain damage in addition to that already caused by the accident. In many cases swelling can be controlled with medication, but in some cases surgery to reduce pressure is needed. A monitor to measure intracranial pressure is sometimes implanted under the survivor's skull to continually monitor pressure. Physicians will run tests such as X-rays, MRIs, and CT scans to assess the site and severity of the injury, as well as to look for bleeding or blood clots. These tests can also give physicians a better idea of the long-term prognosis of the survivor, as well as the types of issues he or she may face as a result of the injury.

b. What Are The Nursing Considerations?

As Kevin Pearce was unconscious the nurse was responsible for every part of Kevin Pearce's existence. The gastrointestinal system for instance required monitoring of elimination and gastric aspirates. Protective measures were taken to prevent predictable complications. Kevin Pearce was carefully repositioned second hourly ensuring joint alignment and the use of ulnar nerve protectors to guard against pressure areas and nerve compression (Szaflarski, 1996). Eye and mouth care were also attended second hourly to prevent corneal and mucosal ulcers from forming. Intermittent pneumatic graduated calf compression devices were used to combat deep vein thromboses forming (Szaflarski, ...