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The veteran exhibiting signs and symptoms of traumatic brain injury would need to be further assessed on multiple levels. It should be determined if this presentation is a new onset for the veteran or if this is a reoccurrence of an existing traumatic brain injury (TBI). If the veteran is recently returning from a deployment or active duty and suffered an injury that was not reported, this may be a new injury that needs immediate attention. In the acute setting, the veteran would need the proper testing such as an MRI or CT of the head. It would be important for the nurse to ask the veteran if they have recently lost consciousness, if they are experiencing a headache, if they are having trouble with their vision or motor skills. A Glasgow coma scale should be performed to establish a baseline for the veteran. According to Martin, Lu, Helmic, French and Warden (2008) the symptoms of a TBI can include headache, memory impairment, disordered thinking, mood changes, difficulty sleeping, dizziness and irritability.
When assessing the veteran with a known traumatic brain injury, it would be important to know how long the patient has had the injury and if the injuries symptoms have been consistent or if they have changed over time. Depending of the severity of the injury the veteran may range from high functioning and may only experience few limiting effects from his/her injury or may completely limited and require total care from another person. During the assessment it will be important for the nurse to build a rapport with the veteran to establish a trusting relationship, as discussed during our week one forum. By talking to the veteran during the assessment, the nurse can determine how things are going for the veteran living with a TBI and assess his/her needs for change depending on if he/she is reporting increased headaches, mood swings, insomnia- for example.
When planning care for the veteran with a TBI, it would be a great resource for the nurse to include the case manager. The case manager would have access to more resources than the bedside nurse when planning discharge or when reaching out for additional home supplies, as an example. According to Cobb and Pridgen (2008) the case manager should consider the safety, psychosocial, disease process, medications, and activity needs of the veteran when planning care. The case manager is also able to assist with the needs of the veteran’s family to some degree.
The veteran exhibiting signs and symptoms of traumatic brain injury would need to be further assessed on multiple levels. It should be determined if this presentation is a new onset for the veteran or if this is a reoccurrence of an existing traumatic brain injury (TBI).