Question

A 42 year-old man is admitted to the emergency room having been in an accident involving a construction site and dynamite. The patient was brought to the hospital and it was explained that a detonation they were working on went off too soon and the worker was thrown to the ground. The patient was seen drinking plenty of water throughout the day. The 42 year-old is conscious, blood pressure is slightly high, her pulse is strong but rapid. The patient is breathing normally. The patient is evidently embarrassed by the events. A nurse asks the patient to describe what happened and these are the symptoms that are noticed as the patient tries to explain the events: His speech is slurred and difficult to understand. The left side of his mouth is drooping, and he is drooling but does not seem to notice. He is speaking loudly as he explains. He keeps asking everyone to speak up. He has trouble remember the sequence of events. The patient’s reflexes are checked, including the ability to touch his nose with his eyes closed. His reflexes are normal; however he is unable to touch his nose with his eyes closed. His movements seem uncoordinated. As the examination continues, the nurse discovers the following: His right ear is scraped up from the fall and needs to be treated. His pupils are dilated. The patient complains of a dry mouth. The patient complains of a massive headache, and is holding the right side of his head. The patient has difficulty walking in a straight line. The nurse believes that the patient has suffered some minor injuries, and the nurse suspects that the patient most likely has a concussion.

Answer the following questions:

Why might his blood pressure be elevated and his pulse be rapid?

What could be causing his slurred speech?

Why might the left side of his lip droop?

Why does he not seem to notice the drool? (Use physiological reason, not psychological).

Why might he be speaking loudly?

Why might he be asking everyone to speak up? Explain why he cannot remember the recent events. (Again, use a physiological explanation, not a psychological one.)

What is the nurse testing by asking the patient to touch his nose with his eyes close?

What does it mean for the patient who cannot touch his nose with his eyes closed?

What could explain why his pupils are dilated?

What explains the dry mouth?

What might explain the problems with balance?

Make a list of the symptoms of a concussion.

What are some recommended treatments for a concussion?

What parts of the patients brain may have suffered an injury based on his symptoms?

Answer 1