The nurse is providing discharge instructions to a client ...

[wrbasek0]

The nurse is providing discharge instructions to a client recovering from a traumatic brain injury. Which of the following should be included in these instructions? (Select all that apply.)
 
  1. Return to a full schedule of work as soon as possible.
  2. Acquire medical clearance prior to returning to work that uses heavy equipment.
  3. Avoid the use of helmets.
  4. Limit the amount of alcoholic beverages.
  5. Avoid all illicit drug use.
  6. Eat a well-balanced diet.

Question 2

The nurse, planning care for a client recovering from a traumatic brain injury, is including interventions to prevent sympathetic storming. Which of the following should be included in this client's plan of care? (Select all that apply.)
 
  1. Medicate for pain prior to conducting a painful procedure.
  2. Elevated blood pressure indicates a sympathetic storm is ending.
  3. Continue suctioning until the client's heart rate is greater than 100 beats per minute.
  4. Cardiac arrhythmias indicate a drop in intracranial pressure.
  5. Provide beta-blockers as prescribed with symptoms of sympathetic storm.
  6. If symptoms of sympathetic storm do not appear within 24 hours, the client will not develop this health problem.

[ttt030911]

Answer to Question 1

2, 5, 6
Discharge instructions for a client recovering from a traumatic brain injury should include: medical clearance is needed prior to returning to work that uses heavy equipment; avoid all illicit drug use; and eat a well-balanced diet. The client should be cautioned to avoid returning to a full schedule of work as soon as possible. The client should be encouraged to use helmets or other safety equipment to protect the head. The clients should be instructed to avoid all alcoholic beverages.

Answer to Question 2

1, 5
The nurse should medicate the client for pain prior to conducting a painful procedure and provide beta-blockers as prescribed with symptoms of a sympathetic storm. An elevated blood pressure is a symptom of sympathetic storm. An elevated heart rate is a symptom of sympathetic storming. Cardiac arrhythmias are also a symptom of a sympathetic storm and do not indicate a drop in intracranial pressure. Symptoms of sympathetic storming can occur within 24 hours after a traumatic brain injury and can reoccur periodically during the recovery process.