Author Question: A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests ... (Read 105 times)

kshipps · **on:** Jun 28, 2018

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests:

a. diabetic coma.
b. brainstem injury.
c. upper respiratory tract infection.
d. leaking of cerebrospinal fluid (CSF).

Question 2

A toddler fell out of a second-story window. She had a brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented.

Her mother asks why a computed tomography (CT) scan is required when she seems fine. Which explanation should the nurse give?
a. Your child may have a brain injury and the CT can rule one out.
b. The CT needs to be done because of your child's age.
c. Your child may start to have seizures and a baseline CT should be done.
d. Your child probably has a skull fracture and the CT can confirm this diagnosis.

gstein359 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: D
Watery discharge from the nose that is positive for glucose suggests leaking of CSF from a skull fracture and is not associated with diabetes or respiratory tract infection. The fluid is probably CSF from a skull fracture and does not signify whether the brainstem is involved.

Answer to Question 2

ANS: A
The child's history of the fall, brief loss of consciousness, and vomiting four times necessitates evaluation of a potential brain injury. The severity of a head injury may not be apparent on clinical examination but will be detectable on a CT scan. The need for the CT scan is related to the injury and symptoms, not the child's age. The CT scan is necessary to determine whether a brain injury has occurred.