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Advanced Medical-Surgical Nursing (NUR 463) Neuro Case study

John Marsh
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University of Rhode Island

Advanced Medical-Surgical Nursing (NUR 463)

NUR463 Neuro Case study

NUR 463
Neurological Case Study
Date: November 17, 2017
Mr. S. is a 23-year-old male who sustained a traumatic brain injury as an
unrestrained driver in a motor vehicle crash. On admission, his blood
pressure (BP) was 158/72 mm Hg, heart rate (HR) 46 beats per minute,
respiratory rate (RR) 28 breaths per minute, and temperature 96.2° F
(35.6° C). His neurological exam reveals that his right pupil is at 6 mm and
reacts sluggishly; his left pupil is 4 mm and reacts briskly. He is nonverbal,
extends his arms bilaterally to pain, and opens his eyes minimally to pain.
He is quickly intubated and placed on mechanical ventilation. A computed
tomography (CT) scan is done, which reveals a large right subdural
hematoma with cingulate herniation from right to left, as well as right-sided
uncal herniation.



Advanced Medical-Surgical Nursing (NUR 463) Neuro Case study

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