Question

Warm-ups for Week 12 (11/9-13) These would normally be in your composition notebook labeled with the date and the day of the week. They will be at the back of the composition notebook. MUST BE WRITTEN IN COMPLETE SENTENCES

Monday 11/9: 1. After SA node (pacemaker) placement, patient’s ECG revealed NSR. 2. What is a concussion? 3. What happens inside the skull of a person following a concussion?

Tuesday 11/10: 1. Patient c MA of 4 requires TLC and OT qd. 2. What are the initial symptoms of a concussion? 3. What must be done following a concussion? Why?

Wednesday 11/11: 1. Patient c sx of bilateral conjunctivitis, rx ii gtts OU tid x 7d. 2. How can concussions be prevented? 3. Who is at risk of a serious complication following a concussion?

Thursday, 11/12: 1. Patient exam c US, pt experienced SVD. 2. What tests can be done to rule out brain swelling and bleeding? 3. If no brain swelling or bleeding is detected, how long should the patient be monitored?

Friday, 11/13: 1. Patient c s/sx of DM; rx GTT pp; NPO p midnight. 2. What precautions should be taken after a concussion when dealing with alcohol or prescription medication? 3. What is recommended referring to returning to regular activities following a concussion?

Answer 1

Monday 11/9: 1. After SA node (pacemaker) placement, patient’s ECG revealed NSR.

Question : What is a concussion?

Answer : "A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth."

Question : What happens inside the skull of a person following a concussion?

Answer : Concussions occur as the result of a traumatic blow to the head that causes the head and brain to move rapidly back and forth in a whiplash-like fashion. The sudden movement causes the brain to bounce and twist around inside the skull, stretching and damaging the delicate cells and structures inside your brain.

Tuesday 11/10: 1. Patient c MA of 4 requires TLC and OT qd.

Question : What are the initial symptoms of a concussion?

Answer : Signs and symptoms of a concussion include:

• headache.
• blurred or double vision.
• dizziness, balance problems, or trouble walking.
• confusion and saying things that don't make sense.
• being slow to answer questions.
• slurred speech.
• nausea or vomiting.
• not remembering what happened.

Question : What must be done following a concussion? Why?

Answer : It's important to seek care from a doctor after a head injury. Getting help early can contribute to a better recovery. If you have a concussion, take good care of yourself in the days and weeks following your injury. Resting both physically and mentally will help ensure you have a quick and complete recovery.All forms of concussions are serious. While urgent care centers may be capable of administering first aid help or the like to a person with a concussion, they will almost certainly be passed onto emergency rooms where there are medical imaging machines like CT scans to help diagnose and pinpoint the concussed area.

Wednesday 11/11: 1. Patient c sx of bilateral conjunctivitis, rx ii gtts OU tid x 7d.

Question : How can concussions be prevented?

Answer : Everyone should wear properly fitting, sport-appropriate headgear and safety equipment when playing contact sports or biking, rollerblading, skateboarding, snowboarding, or skiing. You can't prevent every concussion. But helmets, mouthguards, and other safety gear can reduce the risk of a brain injury.

To reduce the risk of concussions:

• Always wear seatbelts in the car and buckle children in safety seats.
• Wear a helmet that fits when biking, riding a motorcycle, skating, skiing, horseback riding, or playing contact sports. A helmet should be secure and not move when you shake your head, but not be uncomfortably tight.
• Prevent falls on stairs by putting up handrails.
• Install safety gates on stairs to protect young children.
• Put grab bars in the bathroom, with nonslip mats in the tub and on floors.
• Improve lighting and remove trip hazards.
• Install safety guards by windows to keep children from falling out.
• Strengthen your neck muscles. Strong neck muscles may be able to help absorb some of the impact of blows to the head and decrease the risk of concussion.

Question : Who is at risk of a serious complication following a concussion?

Answer : Following a concussion, some people may suffer persisting symptoms, such as memory and concentration problems, mood swings, personality changes, headache, fatigue, dizziness, insomnia and excessive drowsiness for several weeks to months. This is known as post-concussive syndrome.

Potential complications of concussion include:

• Post-traumatic headaches. Some people experience concussion-related headaches up to seven days after a brain injury.
• Post-traumatic vertigo. ...
• Post-concussion syndrome. ...
• Cumulative effects of multiple brain injuries. ...
• Second impact syndrome.

Thursday, 11/12: 1. Patient diagnosis c US, pt experienced SVD

Question : What tests can be done to rule out brain swelling and bleeding

Answer : Computerized tomography (CT) scan.

• A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain (hemorrhage), blood clots (hematomas), bruised brain tissue (contusions), and brain tissue swelling.

Common diagnosis and tests used in the diagnosis include:

• Head and neck test.
• Neurologic test
• CT scan of the head to identify the extent and location of the swelling.
• MRI of the head to identify the extent and location of the swelling.
• Blood tests to check for causes of the swelling.
• Lumbar puncture.

Question : If no brain swelling or bleeding is detected, how long should the patient be monitored?

Answer : patient should be monitored for worsening signs and symptoms in the 24 to 48 hours following the injury.

Friday, 11/13: 1. Patient c s/sx of DM; rx GTT pp; NPO p midnight.

Question : What precautions should be taken after a concussion when dealing with alcohol or prescription medication?

Answer : Alcohol and brain injury recovery

• Recovery from brain injury continues for much longer than we used to think possible. Many people notice improvements for many years after injury.
• Alcohol slows down or stops brain injury recovery.
• Not drinking is one way to give the brain the best chance to heal.
• People's lives often continue to improve many years after brain injury. Not drinking will increase the chance of improvement.
• After a brain injury, survivors are at higher risk (3 to 8 times higher) of having another brain injury.
• Drinking alcohol puts survivors at an even higher risk of having a second brain injury. This may be because both brain injury and alcohol can affect coordination and balance.
• Not drinking can reduce the risk of having another brain injury.

Question : What is recommended referring to returning to regular activities following a concussion?

Answer :

Regular activities can be done in a slow but progressive way in order to restore the health and full recovery.

• Returning to school, work, or other daily responsibilities is the first important step in concussion recovery
• Patients may participate in stationary biking, walking, light jogging, and other similar activities. Patients are typically safe to continue these activities for 5 to 10 minutes at a time.
• More rigorous activities may be resumed (e.g. jogging, weightlifting, etc.), but not at the rate prior to the concussive event.
• Athletes may resume sport-related drills, but should abstain from practice and competitive play. Casual athletes should increase their levels of exertion and the amount of time spent being active.
• . A return to full-contact competitive play or vigorous solitary activities can be made.