Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide • Monitor for pain and give pain medications accordingly; remember that a side effect of narcotics is respiratory depression • Patient and family teaching on skin care, nutrition, respiratory care, turning, and patient safety Expected outcomes for spinal cord injury: • Patient demonstrates adequate ventilation and no respiratory distress • Vital signs are stable • Skin remains free from breakdown • Remains free from injury from immobilization • Verbalizes or demonstrates pain control • Remains free of symptoms of autonomic dysreflexia • Patient and family verbalize understanding of condition, safety measures, and complications Head Injuries Assessment and care for patients with head injuries needs to be done quickly to reduce or prevent swelling of the brain and serious complications. Head injuries can range from mild concussions to fatal brain trauma and death from increased intracranial pressure (ICP). Head injuries are any injuries that involve the skull, the skin covering (scalp), or inside the skull to the actual brain. They can also include all three areas. The main causes of head injury are motor vehicle accidents (MVA), gunshot wounds, falls that result in a blow to the head, assault by another person, sports, and recreation activities, such as ski accidents, boating, and rock climbing. Alcohol use during any of these activities is the number one contributing factor for head injuries. The first assessment emergency personnel should perform is the level of consciousness and GCS, or Glasgow coma scale. It is important to determine the extent of the injuries and assess the rest of the body for injuries including spinal trauma, soft tissue injury, fractures, and internal hemorrhage. When a head injury is encountered, a cervical collar should be placed immediately in case there is associated neck injury. Types of head injury Scalp: These are exterior injuries, but internal brain injuries cannot be ruled out. There may be evidence of contusion/bruising, abrasions, open lacerations, or hematoma. When the scalp is injured, there is heavy bleeding involved due to large blood vessels in the region. Open wounds on the scalp take time to clot and stop bleeding, and are at risk for infection. First aid should stop bleeding and prevent infections. The patient should be monitored for other signs of deeper injuries. Signs and symptoms of scalp injuries: • Heavy bleeding • May complain of headache or pain • Bump or hematoma • Contusions and bruising

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