A nurse is caring for a patient in the intensive care unit who was admitted with severe head trauma and cerebral edema. The patient opens their eyes spontaneously, is oriented, and obeys commands.Which of the following findings indicate the patient is experiencing a decline in their condition?
Patient is confused
Patient mumbles inappropriate words
Eyes do not open to name
The Correct Answer is A
Choice A rationale
A patient in the intensive care unit who was admitted with severe head trauma and cerebral edema, who opens their eyes spontaneously, is oriented, and obeys commands, would be experiencing a decline in their condition if they become confused. Confusion can be a sign of worsening brain function, indicating that the brain is not receiving enough oxygen or is being affected by a buildup of toxins. This could be due to increased intracranial pressure, decreased blood flow to the brain, or further injury to the brain tissue.
Choice B rationale
Mumbling inappropriate words can also be a sign of a decline in a patient’s condition. However, it is less specific than confusion. It could be due to a variety of factors, including medication side effects, sleep deprivation, or mental health issues.
Choice C rationale
If a patient’s eyes do not open to their name, it could indicate a significant decline in their condition. However, this is a more severe symptom than confusion and may not be the first sign of a decline.
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Correct Answer is A
Explanation
Choice A rationale
Rebleeding of the injury is a significant factor related to a high mortality rate for a client who has a subarachnoid hemorrhage (SAH). SAH is a devastating event with substantial mortality and high morbidity among survivors. The most common primary causes of death or neurological devastation leading to withdrawal of support are direct effects of the primary hemorrhage (55%) and aneurysm rebleeding (17%)2. Therefore, rebleeding of the injury is a critical concern in the management of SAH.
Choice B rationale
Decreased cerebrospinal fluid is not directly linked to a high mortality rate in SAH. While changes in cerebrospinal fluid dynamics can occur after SAH, it’s not typically a primary factor contributing to mortality.
Choice C rationale
The use of nimodipine is actually part of the treatment protocol for SAH. Nimodipine is a calcium channel blocker that is used to prevent cerebral vasospasm, a complication of SAH. It does not contribute to a higher mortality rate.
Choice D rationale
Poor functional ability could be a result of SAH due to neurological damage, but it is not a direct cause of high mortality. The severity of the initial hemorrhage and subsequent
complications like rebleeding or medical complications are more directly tied to mortality rates.
Correct Answer is B
Explanation
Choice A rationale
While traumatic brain injuries (TBIs) can occur at any age, people in their 30s are not at the highest risk. Other factors, such as participation in high-risk activities or certain occupations, can increase the risk of TBI, but age alone in this group does not confer a higher risk.
Choice B rationale
People who play contact sports are at a higher risk of sustaining a TBI. Contact sports such as football, boxing, and hockey have a high incidence of TBIs, including concussions.
Choice C rationale
Abstaining from alcohol does not increase the risk of TBI. In fact, alcohol use is a risk factor for TBI, as it can increase the likelihood of falls, car accidents, and other events that can cause TBI1112.
Choice D rationale
Living in rural areas does not inherently increase the risk of TBI. However, certain factors associated with rural living, such as increased travel distances and limited access to trauma
care, can contribute to the severity of a TBI once it occurs. Subarachnoid hemorrhageSubarachnoid hemorrhage Explore
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