After falling, a patient's Glasgow Coma Scale (GCS) was 5 ...

[EAugust]

After falling, a patient's Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day. The pa-tient remained unconscious for 2 weeks but is now awake, confused, and experiencing antero-grade amnesia. This history supports which medical diagnosis?
 
  a. Mild diffuse brain injury
  b. Moderate diffuse brain injury
  c. Severe diffuse brain injury
  d. Postconcussive syndrome

Question 2

Which assessment finding by the nurse characterizes a mild concussion?
 
  a. A brief loss of consciousness
  b. Significant behavioral changes
  c. Retrograde amnesia
  d. Permanent confusion

[cici]

Answer to Question 1

ANS: B
In moderate diffuse axonal injury, the score on the GCS is 4-8 initially and 6-8 by 24 hours, and the person is confused and suffers a long period of posttraumatic anterograde and retrograde amnesia. In mild diffuse axonal injury, coma lasts 6-24 hours, with 30 of persons displaying decerebrate or decorticate posturing. They may experience prolonged periods of stupor or rest-lessness. In severe diffuse axonal injury, the person experiences immediate autonomic dysfunc-tion that disappears in a few weeks. Increased ICP appears 4-6 days after the injury. In postcon-cussive syndrome, the individual experiences headache, nervousness or anxiety, irritability, in-somnia, depression, inability to concentrate, forgetfulness, and fatigability.

Answer to Question 2

ANS: C
Mild concussion is characterized by immediate but transitory confusion that lasts for one to sev-eral minutes, possibly with amnesia for events preceding the trauma. Individuals with extradural hematomas lose consciousness at injury; one third then become lucid for a few minutes to a few days. Persons with diffuse brain injury demonstrate behavioral changes. Individuals with a mild concussion experience transient, not permanent, confusion.