Objectives:

At the end of the discussion, the Level IV nursing Student will be able To:

1. Understand the Definition of TBI.

2. The Risk factors of TBI.

3. Necessary Assessments for Clients with TBI.

4. Nursing Care and management for TBI clients.

5. Drugs to be administered of a client with TBI.

6. Priority Nursing Diagnosis for Clients with TBI.

7. Diagnostic Test for a Client with TBI.

8. Anatomy and Physiology as well as the Pathophysiology of TBI.

 Introduction.
Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force injures the brain. TBI can be classified
based on severity, mechanism (closed or penetrating head injury), or other features (e.g., occurring in a specific location or over a
widespread area). Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can
result in physical, cognitive, social, emotional, and behavioral symptoms, and outcome can range from complete recovery to
permanent disability or death.
Causes include falls, vehicle collisions, and violence. Brain trauma occurs as a consequence of a sudden acceleration or deceleration
within the cranium or by a complex combination of both movement and sudden impact. In addition to the damage caused at the
moment of injury, a variety of events following the injury may result in further injury. These processes include alterations in cerebral
blood flow and the pressure within the skull. Some of the imaging techniques used for diagnosis include computed
tomography and magnetic resonance imaging (MRIs).
Prevention measures include use of protective technology in vehicles, such as seat belts and sports or motorcycle helmets, as well as
efforts to reduce the number of collisions, such as safety education programs and enforcement of traffic laws. Depending on the
injury, treatment required may be minimal or may include interventions such as medications, emergency surgery or surgery years
later. Physical therapy, speech therapy, recreation therapy, occupational therapy and vision therapy may be employed for
rehabilitation.
Risk factors
The people most at risk of traumatic brain injury include:
 Children, especially newborns to 4-year-olds
 Young adults, especially those between ages 15 and 24
 Adults age 60 and older
 Males in any age group
 Complications
Several complications can occur immediately or soon after a traumatic brain injury. Severe injuries increase the risk of a greater
number and more-severe complications.
Altered consciousness
Moderate to severe traumatic brain injury can result in prolonged or permanent changes in a person's state of consciousness,
awareness or responsiveness. Different states of consciousness include:
 Coma.
 Vegetative state.
 Minimally conscious state.
 Brain death.
 Physical complications
 Seizures.
 Fluid buildup in the brain (hydrocephalus).
 Infections.
 Blood vessel damage.
 Headaches.
 Vertigo.
 Intellectual problems
 Cognitive problems
 Executive functioning problems
 Communication problems
 Cognitive problems
 Social problems
 Lab results
9/15/18 Urinalysis Results
Color Yellow
Transparency Hazy
Specific Gravity 1.030
Blood +++
Puss-cells 1-2/hpf
RBC 35-40
Epithelial cells Rare
Bacteria Few
Mucus Threads Rare
Amorphus Urates Few
10/23/18 Urinalysis Results

Color Yellow

Transparency Hazy

Specific Gravity 1.025

Blood +

Puss-cells 16-19

PH 6.5

RBC 4-6

Epithelial cells Rare

Bacteria Few

Mucus Threads Rare

Amorphus Urates Few

11/2/18 Urinalysis Results
Color Yellow
Transparency Hazy
Specific Gravity 1.025
Blood +++
ph 6.5
RBC Abundant
Epithelial cells Rare
Bacteria Few
Mucus Threads Rare
Amorphus Urates Few

Glucose -

Protein -

Ketones -
Complete Blood Count 9/15/18 Results Normal Values
WBC 14.7 5-10
Lymphocytes 6.7 17-57
Granulocytes 92.8 28-78

Complete Blood Count 10/13/18 Results Normal Values

WBC 14.7
Lymphocytes 6.7
Granulocytes 92.8

Complete Blood Count 11/4/18 Result Normal Values

HCT .396 .420-.520

11/14/18 Results Normal Values

Complete Blood Count
RBC 4.41
WBC 14
Granulocytes 81
HGB 130
HCT .388
Creatinine 36.63
11/5/18 Results Normal Values
Po2 192.6 70-100 mmhg
THB 11.0 12-17

11/12/15
P02 108.2 70-100 mmhg
THB 11.8 12-17

10/13/18
Fecalysis
Color: Yellow
Consistency: Soft
Entamoeba histolytica: 1-2/hpf
Pus Cells: 2-5/hpf
RBC: 0-2 HPF
Coagulation Test 9/15/18 Result Normal Values
Control 14.4 Sec
PT 19.0 Sec 11-15 Seconds
% Activity 52% 70-120%
Pro time - -
CBC Normal Values
10/13/18
Radiographic Report
Part examination: Ultrasound of the Inguino Scrotal
Impression: right inguinal complex cyst. Normal study of the testicles and scrotal sac.