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HEAD INJURY

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HEAD INJURY

Any trauma that leads to injury of the

scalp, skull or brain. The injuries canrange from a minor bump on the skull to

serious brain injury.

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Classification

Closed Head Injury

Open or Penetrating Injury

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Types of Brain Injury:

Concussion > jarring of the brain

Contusion > Bruising of the brain.

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Other type ofHead injury

Skull Fracture

Linear Skull Fracture

Depressed Skull Fracture

Basillar Skull Fracture

*Battles Sign

Intracranial Hemorrhage

Subdural Hematoma

Epidural hematoma

Subarachnoid hemorrhage

Intraparenchymal hemorrhage

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Causes:

PAVEMENT

P Pagkalaglag (fall)

A Abuse

V Violence

E Extreme Sports

MMotor /Vehicular accident

E engage in Assault

N Nauntog

T Tatanga-tanga sa Kalsada

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Sign and Symptoms:

Changes in or unequal size of pupils

Severe headache

Fluid drainage from nose and ears

Bruising of the face

Impaired hearing, smell, taste or vision

Loss of consciousness and confusion

Low breathing rate or drop in blood pressure

Vomiting Irritable, personality changes, or unsual behavior

Convulsion

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Assessment

Check ABCs

A irway

B reathing

C irculation

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Drug

Acetaminophen > for mild Headache

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Nursing Management:

DO NOT Do NOT give aspirin, Ibuprofen or other NSAIDs.

Do NOT apply direct pressure to the bleeding a lot.

Do NOT wash a head wound that is deep or bleeding a lot.

Do NOT remove any object sticking out of a wound. Do NOT move the person unless absolutely necessary.

Do NOT shake the person if he or she seems dazed.

Do NOT remove a helmet if you suspect a serious headinjury.

Do NOT pick up a fallen child with any sign of head injury.

Do NOT drink alcohol within 48 hours of a serious headinjury.

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HEART FAILURE

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Definition:

The inability of the heart to pump sufficient blood tomeet the needs of tissue for oxygen and nutrients.

HF often referred to as congestive heart failure becausemany patient experience pulmonary or peripheralcongestive.

HF currently recognize as a clinical syndromecharacterized by:

o Inadequate tissue perfusion

o

Fluid overload HF refers to myocardial disease in which there is a

problem with contraction of the heart or filling of theheart.

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Type:

1. Systolic Heart Failure

= weakened heart muscle

= decreased blood volume being ejected from

the ventricle.

Preload > filling of left ventricle at the end of diastole.

2. Diastolic Heart Failure

= stiff and non-compliant heart muscle.

= increased work-load that lead to ventricular hypertrophy.

After load > amount of resistance to ejection of blood from

a ventricle

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Cause:C Cardiomyopathy

H hypertension

A - Atherosclerosis

D Diabetic Milletus

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Clinical Manifestation

1. Left Sided Heart Failure

(Left ventricular failure)

2. Right sided Heart Failure

(Right Ventricular Failure)

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Left Sided Heart Failure Pulmonary congestion oocurs when the left ventricle

cannot effectively pump blood out of the ventricle. The increase left ventricular end diastolic blood volume

increases the left ventricular end diastolic pressure.

Pulmonary Edema

Palpitation

An extra Heart sound Ventricular Gallop

DyspneaOliguria

Cough

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Right Sided Heart Failure

Congestion in the peripheral tissue and visceralpredominates

Increased venous pressure leads to JVD

Dependent Edema

Hepatomegaly

AscitesWeakness and weight gain

Nausea and vomiting

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Diagnostic Exam

Echocardiogram

> Help to identity the underlying cause and

determine the EF which helps identify the typeand severity of the following.

*Ejection Fraction (EF) = end of systolic end ofdiastole = normal 55-65%

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Medical Management:

4 Goals of Management on Heart Failure1. To relieve the symptoms

2. To improve functional status and quality of

life3. To extend survival

4. To reduce the workload on the heart

(Afterload & Preload)

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Drug Magement:

a. Calcium channel blocker Nifedine &

Amlodipineb. Hydralazine and Isorbide Dinitrate

c. ACE inhibitor Captopril

d. Diurectics Lood, Thiazide & PotassiumSparing Diuretics

e. Beta Blockers Metoprolol

f. Angiotensin II Receptor Blockers Valsopring. Digitalis Digoxin

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Nursing Management

Assessing the patients response to the pharmacologicregimen

Auscultating lung sound to detect an increase ordecrease in pulmonary crackles.

Assess for symptoms of fluid overload

Monitor I&O

Monitor pulse rate and blood pressure

Examine skin turgor and mucous membrane for signsof dehydration

Identify and evaluate the severity of dependentedema.

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THANK YOU

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Open Head Injury

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Concussion

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Contusion

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Depressed Skull Fracture

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Battles Sign

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Intracranial Hemorrhage

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HEART FAILURE

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Left Sided Heart Failure