Please enable JavaScript.
Coggle requires JavaScript to display documents.
59 YO female with Dx of intracranial hemorrhage (Medications…
59 YO female with Dx of intracranial hemorrhage
Intracranial hemorrhage - subarachnoid
Pathophysiology
Localized bleeding around tissues
Blood from trauma irritates brain tissues
Hematoma can form d/t pooling of blood
Increased ICP near brain tissue
Decreased vital BF = brain cell death
Causes
Bursting of brain aneurysm
uncontrolled HTN
old age (BV not as resilient)
Left brain injury = R sided hemiplegia
Aphasia - difficulty formulating words & comprehending them
Expressive aphasia
Receptive aphasia
Aware of limits
Experience depression, anger, frustration
Trouble understanding written text
Agraphia
Patient's S/S
Severe HA d/t increased ICP
Abdominal pain
cervical spinal stenosis
#
#
Intermittent L arm weakness and numbness
#
Hypercholesterolemia
Difficulty formulating words and distinguishing and making connections w/ objects
#
#
Photophobia
Quiet, anxious
#
Low alertness, lethargic
Labs:
Na - 146 :red_flag:
K - 3.9
Cl - 110 :red_flag:
HCO3 - 28
BUN - 20 :red_flag:
Cr - 0.66
Glucose - 111 :red_flag:
Hgb - 11.8 :red_flag:
Hct - 38.1
WBC - 9.3
PLT - 231
PT - 12.0
PTT - 28.1
INR - 0.8
Labs & Diagnostics
CT Scan - Brain
No masses
Hemorrhage in subarachnoid space
#
Brain swelling
#
Medications
amitriptyline
- treat depression
SE - allergic reaction, anxiety, restlessness, chest pain
#
atorvastatin
- treat high cholesterol and triglyceride levels, reduce risk of stroke, MI and heart & BV problems
SE - dark urine, pale stools, fever, muscle pain, tenderness or weakness, unusal tiredness
#
bisacodyl
- treat constipation
SE - lightheadedness
#
carvedilol
- treat high BP, reduce risk of MI
SE - chest pain, leg pain, dizziness, wt gain, trembling, slow HR
#
#
enalaprilat
- treat high BP
SE - chest pain, confusion, dark urine, pale stools, fever
#
#
lisinopril
- treat high BP; reduce risk of MI
SE - dry-hacking cough, hyperkalemia, angioedema
#
#
lorazepam
- relieves anxiety
SE - confusion, unusual mood/behavior, slow HR, worsening of depression
#
nimodipine
- reduce brain damage caused by bleeding from burst blood vessel
SE - tachycardia, dizziness, tiredness
#
oxycodone
- treat moderate to severe pain
SE - anxiety, restlessness, muscle spasms, nausea, extreme dizziness, stomach pain, constipation
#
#
potassium chloride
- prevent hypokalemia
SE = confusion, lightheaded, numbness, tingling, SOB, slow HR upset stomach
prochlorperazine
- treat N/V
SE - fever, chills, sore throat, jerky muscle mvmt, sleepiness, yellow skin/eyes
Interventions
Treat acute pain
Pain management
Pharmalogical
Non-pharmalogical
Report pain on number scale
Provide stool softeners to prevent constipation
#
Safety
#
#
#
#
Assist w/ communication
#
Be patient, listen to patient as they form thoughts
Use interdisplinary approach, work w/ OT/PT/ST
Use therapeutic communication approaches
Patient's Vitals
BP - 136/74
Pulse - 56
RR - 20
Temp - 99.8
SpO2 - 98.2