A client arrives to the emergency department by ambulance. The client has a possible traumatic brain injury after a fall from a roof. Which of the following assessment findings will the triage nurse report to the provider immediately?

Cognitive Function

• Cognitive function in Parkinson's disease can be relatively preserved early on, though some patients may develop cognitive impairment or dementia in later stages.
• Cognitive function can be significantly affected depending on the location and extent of brain damage. Sudden changes in cognition, such as confusion or difficulty forming words, are common in the acute phase following a stroke.
• Cognitive impairment is possible and can vary widely among patients. It is usually more subtle and may include difficulties with concentration and memory rather than dramatic changes.

Speech

• Speech abnormalities are common, such as reduced volume (hypophonia), monotone voice, and difficulty articulating words (dysarthria).
• Speech difficulties, including aphasia or dysarthria, are common, especially if the stroke affects the language centers of the brain.
• Speech problems can include slurred speech (dysarthria) and difficulty with articulation due to muscle weakness or coordination issues.

Mobility Status

• Characterized by bradykinesia (slowness of movement), rigidity, and tremors. Mobility issues are common, with patients often using assistive devices as the disease progresses.

• Mobility issues vary widely based on the affected brain areas. Weakness or paralysis on one side of the body (hemiparesis) and difficulty with gait and balance are common.
• Mobility issues can include weakness, spasticity, and coordination problems. Gait disturbances are common, and assistive devices may be used as the disease progresses.

Blood Pressure

• Blood pressure can vary but is not directly influenced by Parkinson's disease.

• High blood pressure is often a risk factor for stroke and can be present in both the acute phase and later stages.
• Blood pressure abnormalities are not a primary feature of MS, although secondary complications can affect it.

Facial Symmetry

• Parkinson's Disease is characterized by a reduced range of facial expressions (masked face) due to bradykinesia and rigidity, but typically no acute facial droop.

• Facial droop on one side is a common symptom, especially if the stroke affects the facial nerve area or motor control areas.
• Facial weakness or asymmetry can occur, but is less common compared to stroke.

A. There can be slight variations in pupil size but the difference described (one pupil enlarged and fixed, the other constricted and reactive to light) is not considered normal.

B. Age-related changes in pupil size typically involve a gradual decrease in pupil size, not a sudden and dramatic difference between the two eyes.
C. Unequal pupil size, especially when one pupil is fixed and dilated, is a classic sign of increased intracranial pressure (ICP), often caused by head trauma.
D. Exposure to light would cause both pupils to constrict, not one to dilate and fix.