Please I need help with this Case Study: Traumatic Brain Injury…

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Question Answered step-by-step Please I need help with this Case Study: Traumatic Brain Injury… Please I need help with this Case Study:  Traumatic Brain Injury with Increased Intracranial Pressure OBJECTIVESExplain the physiologic mechanisms  that maintain normal intracranial pressure.Describe the common etiologies, clinical manifestations, and interprofessional care of the patient with increased intracranial pressure.Describe the interprofessional and nursing management of the patient with increased intracranial pressure.Differentiate types of head injury by mechanism of injury and clinical manifestations.Patient ProfileD.G., a 19-year-old male, was brought to the emergency department following a motor vehicle accident in which he was the driver. He is transferred to the Neuro-Trauma Intensive Care Unit with a diagnosis of traumatic brain injury.Subjective DataMultiple family members and friends in the waiting roomD.G.’s girlfriend died on sceneHospital chaplain presentObjective DataPhysical ExaminationGlasgow coma scale 4Neurologic Assessment:Pupils 4 mm and sluggishDecerebrate posturingPeriorbital ecchymosisClear drainage from nares is positive for glucoseDiagnostic StudiesComputed tomography (CT) scan: Subdural hematoma compressing the ipsilateral ventricle and causing a midline shiftInterprofessional CareAdmission orders include:Multiple line placements: Arterial monitoring, central venous pressure line, ventriculostomy, and jugular bulb oximetryKeep cerebral perfusion pressure (CPP) > 70 mm HgBegin standing orders for proprofol, midazolam, ranitidine, and phenytoinContinuous cardiac monitoringUrinary catheter with strict I&O measurementsNeuro checks every hourMonitor lab values (arterial blood gases, complete blood count, electrolytes)Discussion QuestionsDescribe the functions of the 12 cranial nerves.Describe the significance of the Glasgow Coma Scale.What significant subjective and objective data related to the nervous system would you obtain?Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies that may be related to D.G.?Based on the assessment data, what are the nursing priorities for D.G.?Indicate the expected outcome associated with each of the medications D.G. is ordered.Describe the purpose and care of D.G.’s ventriculostomy.The resident on call writes an order to insert a nasogastric (NG) tube. Would you implement this order or question it? Why?Describe independent nursing interventions to assist in controlling D.G.’s increased intracranial pressure.Case Study Progress2 hours after admission, D.G. starts experiencing seizures and is unresponsive to tactile stimuli. The left pupil is fixed and dilated to 7 mm. The trauma surgeon suspects D.G. has developed an epidural hematoma.10. What emergency procedure can be done to evacuate an epidural hematoma?11. What additions or changes might you see in D.G.’s care?12. What are the common complications of traumatic brain injuries?Seizure13. Describe seizure, epilepsy, and status epilepticus. 14. Differentiate and describe the two major classes of seizures (generalized and partial) and its types.15.  Describe the purpose, significance of results, and nursing responsibilities related to diagnostic studies of seizures. 16. Describe safety interventions during, and after a seizure.17. Discuss drug therapy related to seizures.  Health Science Science Nursing NSG 252 Share QuestionEmailCopy link Comments (0)

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Question Completing A Nursing Care PlanYou received the patient at 19:00 on day 2. You receive report and review the EHR. The following information is what you discover. Complete the Concept Map by following the instructions on the document. Scenario: Patient IdentityThe patient is a 54-year-old female, who is a housewife with a BMI of 26. This patient has had asthma for most for his life and it has been controlled with medications and avoiding triggers. She has been using an albuterol rescue inhaler approximately 1 time per month for the past year.Presenting ComplaintsShe was brought into the ED 2 day ago, complaining of shortness of breath (SOB) and a productive cough. History of Presenting ComplaintsThe patient was experiencing SOB for the past 2-3 days and was progressively worsening on the day on admission. It was not associated with chest tightness or pain. She was also having persistent productive cough with white sputum since she was last discharged 12 days ago.Past Medical HistoryShe was diagnosed with diabetes mellitus and hypertension 8 years ago. She was newly diagnosed with bronchial asthma in her last admission two weeks ago.Social HistoryThe patient is a widow for 6 years. She is a factory worker and cares for 3 teenage children. She stays in a factory area and has a cat at home. She is a non-smoker and a non-alcoholic.Family HistoryHer mother and father have no known medical illness, but she has a cousin who suffers from bronchial asthma and is frequently admitted to the hosptital.Drug HistoryBronchial Asthma. Pulmicort Flexhaler 180 mcg inhaled twice daily.Proventil HFA administer 2 inhalations repeated every 4 to 6 hours, as needed for acute episodes of bronchospasm.Hypertension Fosinopril sodium tablets is 10 mg dailyHydrochlorothiazide tablet 50 mg, dailyType 2 diabetes mellitusMetformin 500mg orally, twice a dayShe has been compliant with her medication and she had no known drug allergy.    Examination DetailsOn examination, the patient was alert and oriented X3. She was pink and appeared to be hydrated. She was also able to speak in full sentences and was not tachypneic. Her blood pressure (BP) was 152/82mmHg, pulse rate (PR) was 109 beats per minute (bpm) and was afebrile. Her oxygen saturation (SpO2) was 96% under 3 liters of oxygen and her blood glucose was 88.Current LabHemoglobin: 13 g/dLHematocrit: 38%Platelet Count: 200,000/mLWhite blood cell: 15,000/mL Medical DiagnosisPatient was initially diagnosed with Acute Exacerbation of Bronchial Asthma secondary to an upper respiratory infection to rule out pneumonia. However, later in the day when the chest X-ray came back, she was diagnosed with pneumonia with right lower lobe effusion.Management PlanThe patient's current medication was continued and 3 liters of oxygen via a nasal canula was administered. She was also started on an antibiotic after the CXR showed pneumonia with right effusion. Medications Prescribed •             Prednisolone tablets, 30mg daily•             Clarithromycin250-500 mg orally every 12 hours•             Pulmicort Flexhaler 180 mcg inhaled twice daily.•             Proventil HFA administer 2 puffs every 4 to 6 hours, PRN for acute episodes of bronchospasm.•             Fosinopril sodium tablets is 10 mg daily•             Hydrochlorothiazide tablet 50 mg, daily•             Metformin 500mg orally, twice a day      Table 1: Vital Signs from the medical recordDay TimeBPPulseSp)2Blood GlucoseTemperature111.00178/102109100%7097.6oF 14.00152/8210098%   18.40133/7311497% 100oF208.30119/6794100%74  15.20112/8296100% 102.2oFQUESTIONS:1. Etiology that led to the medical diagnosis( What condition led to the current medical diagnosis?) 2. Pathophysiology (What is occurring in the effected organ?) 3. Acute Exacerbation of Bronchial Asthma secondary to Pneumonia: (a). Diagnostic findings,(b). General interdisciplinary treatment plan,  (c). Clinical manifestation (list the objective and subjective symptoms),  4. Care plan for your patient (i.e.: Patient teaching. List all the nursing intervention that should be done for this patient at this time)   Health Science Science Nursing NURS 3400 Share QuestionEmailCopy link Comments (0)
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