Question

Mr. Jackson is a 38-year-old African American that presents with an altered level of consciousness (ALOC). He has been having headaches for the last three months but due to a hectic work schedule he has not been able to go to see his medical practitioner. During his last visit two years ago, his blood pressure was slightly elevated, but he never followed up. Upon arrival to the ED a CT scan is completed and it shows a large bleed near the frontal lobe. What should Mr. Jackson's plan of care include?

Answer 1

Answer :

CT scan shows large bleed near the frontal lobe of the brain.

* frontal lobe of the brain is controls the cognitive skills of human beings.

* like emotional skills, problem solving skills, memory language and judgement and also sexual behavior.

* it will work like control panel our personalities and abilities.

* here due to bleed the client is showing symptoms like altered level of consciousness, and head ache due to decreased oxygen supply to the parts of brain due to bleeding.

* Blood pressure also slightly elevated because due to bleeding the clots may abstructs in the blood vessels, so the pressures may increases.

* due to bleeding there will be a blocked blood vessels it may leads to sroke may come to the clients.

Plan of care :

* first we need to check the vital signs of clients.

* there will be chance to clot it may leads to high blood pressure, and rupture also may taken place.

* so for hypertension anti hypertensive drugs should be given like nitroglycerin, mannitol ( decreases the intracraneal pressure).

* for head ache we can give tramadol injection.

* but we should not give aspirin or heparin may increases bleeding.

* give multivitamin injection in 100 ml ns. It may useful to maintain normal neurological functions.

* to reduce bleeding we can give tranexamic acid 500 mg, tid.

* here if any clot formation we seen in CT Scan we can give Altiplase lV r-tPA can give through lv line, to desolve clot.

* if we devolves clot blood pressures also can decreases.

* blood flow increases to the brain and head ache also decreases.

* After providing symptomatic care Emergency surgery is important here that is by craneotomy surgery, to remove the bleeding and minimize the still more complications to brain.

* patient need to be keep in nothing by mouth because is in altered level of consciousness.

* by using Glasgow coma scale see the level of consciousness and put rules tube for input of feedings and Foley catheter for out put of urine.

* maintain intake and out put chart.

* maintain nurses notes.

* post client for surgery as required.

These care we can plan for Mr. Jackson.