Case
NUR 463 Neurological Case Study
- Institution
- University Of Rhode Island
This is a comprehensive and detailed case study on Neurological Case Study for Nur 463. *Essential Study Material!!
[Show more]
Content preview
NUR 463Neurological Case Study
Name:
Date: November 17, 2017
Mr. S. is a 23-year-old male who sustained a traumatic brain injury as an
unrestrained driver in a motor vehicle crash. On admission, his blood
pressure (BP) was 158/72 mm Hg, heart rate (HR) 46 beats per minute,
respiratory rate (RR) 28 breaths per minute, and temperature 96.2° F
(35.6° C). His neurological exam reveals that his right pupil is at 6 mm and
reacts sluggishly; his left pupil is 4 mm and reacts briskly. He is nonverbal,
extends his arms bilaterally to pain, and opens his eyes minimally to pain.
He is quickly intubated and placed on mechanical ventilation. A computed
tomography (CT) scan is done, which reveals a large right subdural
hematoma with cingulate herniation from right to left, as well as right-sided
uncal herniation.
He is taken to surgery emergently for a craniotomy to remove the subdural
hematoma. After surgery, he arrives in the critical care unit with a
ventricular catheter to measure intracranial pressure (ICP). His initial ICP is
24 mm Hg, BP 130/67 mm Hg, mean arterial pressure (MAP) 88 mm Hg,
HR 54 beats per minute, RR 12 breaths per minute (controlled ventilation),
and temperature 96.1° F (35.5° C). His current Glasgow Coma Scale
(GCS) score is 3, but the anesthesiologist did not reverse the anesthesia,
choosing to allow it to wear off gradually. He has orders for 3% saline at 20
mL/hr intravenously.
1. Based on the information provided, what is Mr. S.’s preoperative
GCS? What is the significance of this number, and how would the
nurse describe this to his family?
Mr. S.’s preoperative GCS score was five. He received a one for being
nonverbal, a two for opening his eyes minimally to the response of pain and
another two for extending his arms to pain which indicates decerebrate
posturing. Based on his score of five, Mr. S would be described as in a
comatose state. I would explain to the family that this scale is a
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller anyiamgeorge19. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
73918 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now