Trauma to the skull resulting in mild to extensive damage to the brain. Complications can include cerebral bleeding, hematomas, uncontrolled increased ICP, infections & seizures.
- Assess orientation q 1 hr (early signs of Increased ICP is alterations in orientation).
- Check VS (rise in BP with widening pulse pressure and slow HR can indicate increase ICP)
- Check PERLA (pupil changes)
- Check nose and ears of CSF Leakage. Complete Neuro Assessment.
- Assess for HA, N/V (could be a sign)
- -->Increased ICP can impede circulation to the brain, impede absorption of CSF, affect function of nerve
- cells, and lead to brainstem compression & death.
Seizure Precautions, prophylactic anticonvulsants may be administered.
Narcotic analgesic contraindicated b/c it masks signs of ICP
Instruct client to avoid coughing b/c may increase ICP
Maintain HOB elevated to reduce venous pressure
Monitor for signs of infection.
- Craniotomy incision through cranium to removed accumulated blood or a tumor. Complications include Diabetes Insipidus and SIADH (measure urine specific gravity)