Question

you are caring for a patient following a fall from a ladder the patient is alert and oriented the family reports the patient has an altered personality and voices concern the patient most likely is experiencing what

Answer 1

Ans) As this is a non-emergent situation, the nurse gathers contextual information about the patient related to his health status from a focused chart review.

- Includes recently documented objective and subjective data, recent changes in interventions e.g. medication, and recent or last lab results such as complete blood count (CBC), electrolytes, etc.
General survey Assess patient’s overall condition. Critically compare
your findings in the chart (baseline) with the findings of your general survey. Make particular note of color, activity, interactions, position of the patient, general signs of discomfort or distress (i.e. dyspnea).
Vital signs Obtain baseline information from the chart to compare with current findings to help guide the assessment and determine change in health status.

An elevated temperature, pulse and respirations could indicate an underlying inflammatory response triggered by an infection such as URI, UTI, influenza, etc., or other undiagnosed health problems like hyperthyroidism, etc.
Changes in blood pressure could reflect other stressors requiring further assessment.

- A brain injury is emotionally traumatic. People can respond with frustration, anger, anxiety, and depression to their changed capabilities and life circumstances. It is normal to mourn the life you once had and to try to find ways to cope with a new way of life and personality.

- While many people know that brain injury can cause physical problems such as headaches, dizziness, impaired memory and problems with balance and walking, what's often unseen – except by family members, friends and even some survivors themselves – are personality changes that come when brains have been wounded.