Question

A nurse is creating a plan of care for an infant with an epidural hematoma from a head injury. What interventions should the nurse perform?

Answer 1

A nurse caring for an infant with an epidural hematoma should perform interventions that include monitoring vital signs and neurological status, managing intracranial pressure, ensuring proper fluid balance and equipment availability, collaborating with the medical team, and educating and supporting the family.

Step-by-step explanation:

A nurse is responsible for providing care to an infant with an epidural hematoma resulting from a head injury. The interventions a nurse should perform involve several critical steps to ensure proper recovery and prevent further complications. These include:

• Monitoring vital signs: Regular checks on the infant's heart rate, breathing, and blood pressure.
• Neurological assessments: Observing for any changes in pupil size, level of consciousness, and motor function to assess neurological status.
• Pressure monitoring: Keeping track of intracranial pressure (ICP), which should remain within safe limits to prevent further injury to the brain.
• Managing fluids and electrolytes: Ensuring the infant receives the correct amount of fluids and that electrolyte levels are balanced, as per physician's orders.
• Ensuring proper equipment availability: Confirming that all necessary medical devices are present and functioning.
• Collaboration with the medical team: Working in conjunction with the surgeon, anesthesia professional, and other staff for a cohesive care approach.
• Family support and education: Providing information to the family about the infant's condition, treatment, and prognosis.

Answer 2

When creating a plan of care for an infant with an epidural hematoma, the nurse should monitor vital signs, assess neurological function, create a calm environment, prevent seizures, maintain fluid balance, coordinate with the healthcare team, and provide support to the family.

Step-by-step explanation:

When creating a plan of care for an infant with an epidural hematoma from a head injury, the nurse should perform the following interventions:

1. Monitor the infant's vital signs, including respiratory rate, heart rate, and blood pressure.
2. Assess the level of consciousness and neurological function regularly, looking for any changes or deterioration.
3. Ensure a quiet and calm environment to minimize stimulation.
4. Implement measures to prevent seizures, such as administering anti-seizure medications as prescribed.
5. Monitor and maintain proper fluid and electrolyte balance.
6. Coordinate with the healthcare team to arrange for any necessary diagnostic tests or surgical interventions.
7. Provide emotional support to the infant's family.