HEAD INJURY

HEAD INJURY

Any trauma that leads to injury of the scalp, skull or brain. The injuries can range from a minor bump on the skull to serious brain injury.

Classification Closed Head Injury

Open or Penetrating Injury

Types of Brain Injury:

Concussion > jarring of the brain

Contusion > Bruising of the brain.

Other type of Head injury Skull Fracture

Linear Skull Fracture Depressed Skull Fracture Basillar Skull Fracture *Battles Sign

Intracranial Hemorrhage
Subdural Hematoma Epidural hematoma Subarachnoid hemorrhage Intraparenchymal hemorrhage

Causes:
PAVEMENT
P Pagkalaglag (fall) A Abuse V Violence E Extreme Sports M Motor /Vehicular accident E engage in Assault N Nauntog T Tatanga-tanga sa Kalsada

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

Assessment Check ABCs

A irway B reathing C irculation

Drug

Acetaminophen > for mild Headache

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 head injury. Do NOT pick up a fallen child with any sign of head injury. Do NOT drink alcohol within 48 hours of a serious head injury.

HEART FAILURE

Definition:
The inability of the heart to pump sufficient blood to meet the needs of tissue for oxygen and nutrients. HF often referred to as congestive heart failure because many patient experience pulmonary or peripheral congestive. HF currently recognize as a clinical syndrome characterized by:
o o Inadequate tissue perfusion Fluid overload

HF refers to myocardial disease in which there is a problem with contraction of the heart or filling of the heart.

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

Cause:
C Cardiomyopathy H hypertension A - Atherosclerosis D Diabetic Milletus

Clinical Manifestation
1. Left Sided Heart Failure (Left ventricular failure)

2. Right sided Heart Failure (Right Ventricular Failure)

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 Dyspnea Oliguria Cough

Right Sided Heart Failure

Congestion in the peripheral tissue and visceral predominates Increased venous pressure leads to JVD

Dependent Edema Hepatomegaly Ascites Weakness and weight gain Nausea and vomiting

Diagnostic Exam
Echocardiogram > Help to identity the underlying cause and determine the EF which helps identify the type and severity of the following. *Ejection Fraction (EF) = end of systolic end of diastole = normal 55-65%

Medical Management:
4 Goals of Management on Heart Failure 1. To relieve the symptoms 2. To improve functional status and quality of life 3. To extend survival 4. To reduce the workload on the heart (Afterload & Preload)

Drug Magement:
a. Calcium channel blocker Nifedine & Amlodipine b. Hydralazine and Isorbide Dinitrate c. ACE inhibitor Captopril d. Diurectics Lood, Thiazide & Potassium Sparing Diuretics e. Beta Blockers Metoprolol f. Angiotensin II Receptor Blockers Valsoprin g. Digitalis Digoxin

Nursing Management
Assessing the patients response to the pharmacologic regimen Auscultating lung sound to detect an increase or decrease 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 signs of dehydration Identify and evaluate the severity of dependent edema.

THANK YOU

Open Head Injury

Closed Head Injury

Concussion

Contusion

Depressed Skull Fracture

Battles Sign

Intracranial Hemorrhage

HEART FAILURE

Left Sided Heart Failure