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A pt is admitted to the hospital with a cerebral contusion. During the night, he develops a headache, vomits, and seems more lethargic. What are the appropriate actions for the nurse to take?

Option 1: Administer pain medication
Option 2: Monitor the pt closely and document changes
Option 3: Discharge the pt
Option 4: Perform a neurological assessment

1 Answer

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Final answer:

When a patient with a cerebral contusion develops new symptoms like a headache, vomiting, and lethargy, the nurse should monitor the patient and document changes, and perform a neurological assessment to determine the need for further intervention.

Step-by-step explanation:

Appropriate Actions for a Nurse When a Patient Develops New Symptoms

If a patient is admitted to the hospital with a cerebral contusion and during the night develops a headache, vomits, and seems more lethargic, the appropriate actions for a nurse would include:

  • Monitoring the patient closely and documenting any changes in their condition (Option 2).
  • Performing a neurological assessment to evaluate for any further deterioration or complications (Option 4).

Administering pain medication without further assessment (Option 1) may not be appropriate until the underlying cause of the symptoms is better understood. Discharging the patient (Option 3) would be inappropriate and dangerous given their worsening condition. It is essential to understand that symptoms such as headache, vomiting, and increased lethargy can indicate serious complications, such as increased intracranial pressure, that require immediate medical attention.

A rapid assessment of neurological function is critical in emergency situations because it allows healthcare providers to quickly identify the location and severity of a nervous system injury, providing a lead for further testing and treatment options, as seen with the patient who experienced a sensation of pins and needles before being diagnosed with a potential stroke.

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