OliviaReynolds 17 is a victim of a MVC and was unresponsive at the scene for approximately 2 minutes

/in /by

OliviaReynolds 17 is a victim of a MVC and was unresponsive at the scene for approximately 2 minutes

Instructions
1. Each question is weighted
2. Reference as per APA format, need reference after each question and last page as well.
Mandatory reference: Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical care nursing: Diagnosis and management (8th ed.). St. Louis,
Mo.: Elsevier/Mosby
Case Study
OliviaReynolds, 17 is a victim of a MVC and was unresponsive at the scene for approximately 2 minutes. She had a large laceration to the back of his head and several abrasions and possible fractures. She had serosanguinous drainage from left ear. At the scene paramedics loaded her on a long spine board and applied C-collar.
On arrival at the hospital Olivia was unresponsive. Bloodwork, x-rays and CT were ordered.
Results:
Hgb: 79
CK: 1879
CT of spine:
No fracture or dislocation seen
CT of head:
Right side shows acute subdural hematoma and small focal areas of fresh hemorrhage to frontal and temporal lobe. And midline shift
Effacement of cerebral sulci which suggests brain edema
Skull x-ray
Transverse and longitudinal fracture of temporal bone
1. A Trauma Alert is called. Explain initial assessments of patient in ER. Olivia initially had a GCS of 12 and now has a GCS of 8. What is the significance of the GCS and what would nurse anticipate? (5 marks)
2. Differentiate the types of skull fractures associated with head trauma. What clinical presentations and pathophysiology are pertinent in these types of trauma?(4 marks)
3. Define ICP. What methods are available for monitoring ICP? Describe the potential complications of ICP monitoring.(10 mark)
4. Olivia is ordered to receive Mannitol. Why would this medication be ordered? What assessment is required? What are potential complications of this therapy?(4 marks)
5. Olivia is experiencing hyperventilation and has a PAco2 level of 52. She has an ICP of 20 mmHG. As the nurse what do you know this could lead to?. How will you control it?. Please relate to Monro-Kellie hypothesis.(5 marks)
6. Olivia’  s BP IS 130/88 and ICP is 12. What is her CPP? How did you calculate it and how would you interpret the result? ( 3 marks)

7. 36 hours later in the ICU, Olivia’s urine output suddenly increases to 500 mL/hr. What does the nurse suspect? What lab findings would
support this? What is causing this symptom and what treatment would the nurse anticipate? (4 marks)
8. Olivia’s BP is 180/40. HR 42 and Respiratory Rate of 8. What does the nurse suspect and why? Please explain significance of this finding. (3
marks)
9. Olivia had signed a donor card. TGLN has been notified. Explain the procedure involved in declaration of neurological determination of death
and nurse’s role(10 marks)