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Original Question

I need help with this case study D.G , is 19 year old male, was brought to the emergency department following a motor vehicle in which he was the driver. He is transferred to the Neuro-Trauma Intensive care unit with a diagnosis traumatic brain injury Subjective data 1. Multiple family members and friends in the waiting room 2. D.G girlfriend does on scene 3. Hospital chaplain present Objective data 1. Glasgow coma scale 4 2. Neurogenic Assessment Pupils 4cm and sluggish Decerebrate posturing Peri orbital ecchymosis 3. Clear drainage from bares is positive for glucose Diagnostic studies Computed tomography (CT) scan: subdural hematoma compressing the ipsilateral ventricle and causing a midline shift Admission order include: 1. Multiple line placement: Arterial monitoring, central venous pressure line, ventriculostomy , and jugular bulb oximetry 2. Keep cerebral perfusion pressure (CPP) > 70mm Hg 3. Begin standing order for propofol, midazolam, ranitidine, and phenytoin 4. Continuous cardiac monitoring 5. Urinary catheter with strict I & O measurements 6. Neuro checks every hour 7. Monitor lab values ( arterial blood gases, complete blood count, electrolytes ) Question 1. Describe the function of the 12 cranial nerves 2. What significant subjective and objective data related to the nervous system would you obtain? 3. Based on the assessment data, what are the nursing priorities for D. G? 4. Describe the purpose and care of D. G ventriculostomy 5. Describe independent nursing interventions to assist in controlling D. G increased intracranial pressure. Case study progress 2 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 suspect D.G has developed an epidural hematoma Question 6. What additions or changes might you see in D.G care? 7. Describe seizure, epilepsy and status epilepticus 8. Describe the purpose, significance of results, and nursing responsibilities related to diagnosis studies of seizures 9. Discuss drug therapy related to seizures

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