Page 2476 - Saunders Comprehensive Review For NCLEX-RN

hematomas, uncontrolled increased ICP, infections,
and seizures.
3. Changes in personality or behavior, cranial nerve
deficits, and any other residual deficits depend on the
area of the brain damage and the extent of the
damage.
B. Types of head injuries (Box 69-18)
1. Open
a. Scalp lacerations
b. Fractures in the skull
c. Interruption of the dura mater
2. Closed
a. Concussions
b. Contusions
c. Fractures
C. Hematoma
1. A collection of blood in the tissues that can occur as a
result of a subarachnoid hemorrhage or an
intracerebral hemorrhage.

2. Assessment

a. Assessment findings depend on the
injury.
b. Clinical manifestations usually result
from increased ICP.
c. Changing neurological signs in the
client
d. Changes in level of consciousness
e. Airway and breathing pattern changes
f. Vital signs change, reflecting increased
ICP (rise in blood pressure with
widening pulse pressure; slowing of
pulse)
g. Headache, nausea, and vomiting
h. Visual disturbances, pupillary changes,
and papilledema
i. Nuchal rigidity (not tested until spinal
cord injury is ruled out)
j. Cerebrospinal fluid (CSF) drainage from
the ears or nose
k. Weakness and paralysis
l. Posturing
m. Decreased sensation or absence of
feeling
n. Reflex activity changes
o. Seizure activity

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