Neurological checks for head injuries
LTC Clinical Pearls: Powered by HCPro's Long-Term Care Nursing Library, January 8, 2013
Want to receive articles like this one in your inbox? Subscribe to LTC Clinical Pearls: Powered by HCPro's Long-Term Care Nursing Library!
- Assess the resident for changes in level of consciousness, which is a cardinal sign of untoward pathology. Assess the resident immediately after the fall, then frequently throughout the shift. Assessment should continue for a minimum of 72 hours.
- Observe the resident for obvious injuries to the scalp, including lacerations, bruises, or contusions; confusion; memory loss; difficulty speaking; gait or balance problems; pupils of unequal size or reactions; headache; vomiting; visual disturbances; or periods of coherence alternating with periods of confusion or lethargy. Monitoring must continue for a minimum of 72 hours (or until the resident is asymptomatic for a specified period of time).
- Perform frequent neurologic assessments every:
- 15 minutes for two hours
- 30 minutes for two hours
- 60 minutes for four hours
- Eight hours for 16 hours
- Eight hours until at least 72 hours have elapsed and resident is stable
- Neurological assessments include (at a minimum) pulse, respiration, and blood pressure measurements; assessment of pupil size and reactivity; and equality of hand grip strength. Completing the Glasgow Coma Scale immediately, then once each shift following a head injury, helps keep findings objective.
Want to receive articles like this one in your inbox? Subscribe to LTC Clinical Pearls: Powered by HCPro's Long-Term Care Nursing Library!
Related Products
-
PPS Alert for Long-Term Care
Looking for a tool to make your job easier? PPS Alert for Long-Term Care, exclusively for the RN or MDS coordinator, is your...
-
Billing Alert for Long-Term Care
It's essential to know how to correctly submit your Medicare claims in order to get the reimbursement your facility...
-
CNA Training Advisor: Lesson Plans for Busy Staff Trainers
Save time and money with your in-service training! Get fresh ideas, lesson plans, course materials, and quizzes from a...
-
MDS 3.0 Insider
MDS 3.0 Insider goes beyond the regulations and provides real-world advice and tips to help you evaluate your processes to...
-
The Long-Term Care Nursing Assistant's Guide to Advanced Restorative Skills
This book is written specifically for RNAs or nursing assistants to help them provide quality restorative care. Author...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Steps for maintaining patient privacy
- Note similarities and differences between HCPCS, CPT® codes
- Nursing responsibilities for managing pain
- Know guidelines and subtle differences in code descriptions for laceration repairs
- Q&A: Primary, principal, and secondary diagnoses
- Practice the six rights of medication administration
- Poor documentation: The consequences
- OB services: Coding inside and outside of the package
- Tip of the week: Always report appropriate application code
- E-mailed
-
- Q&A: How should we code fluoroscopy for outpatient procedures?
- Q&A: Backdating an inpatient admission
- Mentor moment: CMS says providers cannot use condition code 44 to backdate observation services
- Correctly code for new cardiac, pulmonary rehab benefits
- Confusion Prevails Over M0102 and M0104
- Coding tip: Understand functional rhinoplasty procedures
- Searched