Temporal lobe - brain herniates through a fracture or surgical site (external hernia)
Priority nursing interventions for a patient post cranial surgery are to prevent:
Increased intracranial pressure (ICP) and infection
Meningitis vs. Encephalitis:
Common cause: Bacterial vs. viral
Increased ICP from: Increased CSF vs. cerebral edema
Onset: Rapid vs. slow
Inflammation of: Pia & arachnoid maters vs. brain
Source: Respiratory infection vs. insect bite
Meningitis:
Most commonly bacterial
Increased CSF
Rapid onset
Inflammation of pia & arachnoid maters
Commonly from a respiratory infection
Encephalitis:
Most commonly viral
Increased cerebral edema
Slow onset
Inflammation of brain
Commonly from insect bite (e.g. West Nile)
A patient is admitted to the ER with a large laceration on the forearm as a result of a dog bite. A pack of dogs on the edge of town attacked him, but scattered when another person intervened with a stick. The nurse informs the patient that the incident will be reported to the public health officials and adds that:
A. Rationale: The priority in treatment is to determine whether the animal is rabid. No treatment is required if a domestic animal can be caught and develops no symptoms of rabies for 10 days or if a wild animal can be killed and the brain has no evidence of rabies. In all other cases, full rabies immunization is required. The initial immunization is a rabies immune globulin followed by active immunization. If immunization is delayed until symptoms develop, rabies infection is ultimately fatal.
