Page 2044 - Saunders Comprehensive Review For NCLEX-RN

▪ Compound

▪ Comminuted

Epidural Hematoma

▪ The most serious type of hematoma, epidural hematoma forms rapidly and
results from arterial bleeding.

▪ The hematoma forms between the dura and skull from a tear in the meningeal
artery.
▪ It is often associated with temporary loss of consciousness, followed by a lucid
period that then rapidly progresses to coma.
▪ Epidural hematoma is a surgical emergency.

Subdural Hematoma

▪ Subdural hematoma forms slowly and results from a venous bleed.
▪ It occurs under the dura as a result of tears in the veins crossing the subdural
space.

Intracerebral Hemorrhage

▪ Intracerebral hemorrhage occurs when a blood vessel within the brain ruptures,
allowing blood to leak inside the brain.

Subarachnoid Hemorrhage

▪ A subarachnoid hemorrhage is bleeding into the subarachnoid space. It may
occur as a result of head trauma or spontaneously, such as from a ruptured
cerebral aneurysm.

Box 58-10

Nursing Care Following Craniotomy

▪ Monitor vital signs and neurological status every 30 to 60 minutes.

▪ Monitor for increased intracranial pressure (ICP).
▪ Monitor for decreased level of consciousness, motor weakness or paralysis,
aphasia, visual changes, and personality changes.

▪ Maintain mechanical ventilation and slight hyperventilation for the first 24 to 48
hours as prescribed to prevent increased ICP.
▪ Assess the primary health care provider’s (PHCP’s) prescription regarding client
positioning.
▪ Avoid extreme hip or neck flexion, and maintain the head in a midline neutral

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