Topic
Health Assessment
Instructions
Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-hour observation for mild concussion following a motor vehicle accident. Randy lost consciousness during the accident and was very confused when he arrived in the ER after EMS transport. He is an Iraq war veteran and he seemed to think after the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual problems from a couple of explosive incidents that occurred while he was in Iraq. The physician is unsure whether Randy’s current symptoms are from the car accident or from prior injuries so he has referred him for consultations to both a neurologist and to a behavioral health specialist.
Based on the above please discuss the following.
- Pathophysiology of concussive injuries and treatment
- Neurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)
- Current best practices associated with post-traumatic stress disorder (PTSD)
- Nursing interventions you would include in this patient’s plan of care
Answer preview
A concussion, which is actually a mild traumatic brain injury, can occur when any kind of external force impacts with an individual’s head. Once this happens, the person’s brain will naturally decelerate or accelerate as a direct result of the angular or rotational forces that result from impact. Violent impact or sudden movement causes the release of a wave of energy which travels through brain tissue, and this can affect physiological, metabolic, and ionic function. Upon impact or sudden movement, even though the skull of the affected individual is not moving, the energy wave that has been unleashed still propels the brain forward and causes it to roughly impact against the skull.
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