1. The client/caregiver can list general facts about head injury.
   1. It causes about 80,000 deaths per year.
   2. Half of traumatic brain injuries are caused by collisions involving cars, motorcycles, or bicycles.
   3. It is the major cause of death in individuals who are 1 to 35 years old but affects all ages.
   4. Infants and small children can receive brain injuries as a result of being shaken violently.
   5. The brain swells after injury, causing pressure.
   6. The risk of traumatic brain injury is highest in children (0 to 4 years old) and adolescents (15 to 19 years old).
   7. All persons with head injuries should be examined by a physician.
2. The client/caregiver can list various types of head injury.
   1. Scalp injury—lacerations, abrasions, and hematomas
   2. Skull fractures—may have drainage from ears and nose, headache, hearing impairment, bruising around the eyes
   3. Concussions—may cause amnesia, headache, nausea, vomiting, dizziness, and a loss of consciousness for 5 minutes or less
   4. Contusions—may cause mental changes, paresis or paralysis, unequal pupils
   5. Subdural hematoma—blood that accumulates between brain and skull
3. The client/caregiver can list symptoms of a mild brain injury.
   1. Brief period of unconsciousness
   2. Headache
   3. Confusion
   4. Dizziness
   5. Blurred vision, ringing in the ears, or a bad taste in the mouth
   6. Mood changes
   7. Memory or concentration problems
4. The client/caregiver can list signs and symptoms of a moderate or severe injury.
   1. Persistent headache
   2. Repeated vomiting or nausea
   3. Convulsions or seizures
   4. Inability to awaken from sleep
   5. Dilation of one or both pupils of the eyes
   6. Slurred speech
   7. Weakness or numbness in the extremities
   8. A loss of coordination
   9. Increased confusion or agitation
5. The client/caregiver can list symptoms and signs to watch for in a child with a brain injury.
   1. They may refuse to eat.
   2. They may appear listless or cranky.
   3. Sleep patterns and performance in school may change.
6. The client/caregiver can list symptoms that indicate need for evaluation by a physician.
   1. Increased confusion, lethargy, and behavior changes
   2. Incoordination, weakness in extremities
   3. Leakage of clear fluid from ear, nose, or throat
   4. Visual changes, blurred vision, double vision, and so forth
   5. Change in judgment, memory, and concentration
   6. Slurred speech
   7. Change in size of one pupil
   8. Vomiting
   9. Restlessness
7. The client/caregiver can list measures to prevent brain injuries.
   1. Always use seat belts in motor vehicle. Use appropriate car seats for children.
   2. Never drive under the influence of drugs or alcohol.
   3. Store firearms (unloaded) in locked cabinet. Store bullets somewhere else.
   4. Wear helmets when
      • Riding bike, skateboard, motorcycle, snowmobile, or all-terrain vehicles
      • Batting or running bases or playing contact sports
   5. Use home safety teaching guide to safety proof home for adults and children.
   6. Inspect playground equipment and supervise children using it.
   7. Regular vision tests can reduce risk of falling.
8. The client/caregiver can state measures for management of a head injury.
   1. Give medications as ordered and report any side effects.
   2. Keep follow-up appointments with physician and therapists.
   3. Avoid alcohol, driving, unsupervised smoking, and the use of hazardous equipment.
9. The client/caregiver can state possible complications.
   1. Coma
   2. Seizures
   3. Infections (meningitis most common)
   4. Nerve damage to facial muscles or nerves involving eye movements
   5. Cognitive losses (short-term memory is most common)
   6. Sensory problems (clumsy, double vision, taste, and smell changes)
   7. Swallowing problems
   8. Trouble with spoken and written language
   9. Personality change (impulse control and inappropriate behavior common)

Resources

Brain Injury Association of America
www.biausa.org

Counseling for Prolonged Stress to the Family
Rehabilitation Centers
Agencies for Financial Assistance

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott
Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com