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An initial period of unconsciousness followed by a lucid interval and then decreased LOC is characteristic of...
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Epidural bleed
What are signs and symptoms of spinal fluid leakage secondary to a dural tear from a basilar skull fracture?
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Rhinorrhea, otorrhea and sniffing.
An ischemic stroke can be treated with thrombolytics within _______ hours.
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3
Bilateral, dilated and fixed pupils are a sign of...
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herniation
Pinpoint pupils are a sign of...
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pons damage or drugs
A basilar skull fracture is an absolute contraindication for the insertion of...
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NG tube and nasal intubation
Any change in LOC is called...
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concussion
_______ injuries occur between the dura and inner surface of the skull.
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Epidural
_______ is given to decrease spinal cord inflammation from vasogenic edema. Not given if clear head injury.
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Dexamethasone
A _______ is a bruising that can lead to bleeding, swelling or hemorrhagic infarction. Can increase ICP.
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contusion
What type of injury is caused by shearing or tearing which leads to axonal changes related to swelling and widespread bruising?
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Diffuse Axonal Injury
How is the rebleed risk from a diffuse axonal injury decreased?
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By preventing sudden BP increases. The most commonly used medications to achieve this are: Nipride, Propranolol, and Hydralazine (hypertension crisis).
The ICP drainage bag is placed at the _______ for balancing. Fluid is removed when ICP is _______.
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tragus; 20 or higher for 5 minutes
A unilateral, dilated pupil is a sign of CN _______ compression.
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CN III oculomotor (or mydriatic eye drops)
A _______ lab is important with an ischemic brain injury because it allows for H and H monitoring.
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CBC
What substance can predispose patients with head trauma for bleeding?
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Cocaine
A sudden decrease in ICP is a sign of...
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brain death
A _______ is the best tool for visualizing basilar skull fracture, hemorrhagic strokes and is done with no contrast dye.
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CT scan
A _______ is the best tool to diagnose ischemic strokes.
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MRI
No _______ intubation if basilar fracture. No _______ intubation if C-spine injury.
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no NT for basilar (or NG); no ET for C-spine
_______ is given to prevent seizures. Monitor gums for hypertrophy.
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Dilantin
Sedation is only given if a brain injured patient is at risk for...
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injury
For increased ICP, HOB should be _______. Seizures; patient should be _______.
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30 degrees; side-lying
_______ are used to increase BP and blood perfusion to the brain. They aren't given if increased ICP.
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Vasopressors
CO2 should be more than _______ or less than 2 to prevent vasoconstriction in patients with increased ICP.
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35
CSF tests: Halo = collect _______ look for... Glucose = collect _______ look for...
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collect fluid with blood (yellow ring) = positive; glucose: no blood can be present
_______ is the pressure needed to ensure blood flow to the brain.
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Cerebral Perfusion Pressure (CPP) CPP = MAP - ICP
What is a normal CPP?
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60-100
PaCO2 _______ when high and _______ when low.
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high = vasodilates (relaxes smooth muscle); low = vasoconstriction (increases resistance)
Secondary head trauma is _______ and includes injuries from ischemia or infection.
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preventable


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