HESI Evolve Case Study Head Injury Answers?

1. observe the area behind jeff's ears
2. observe for a halo around the spot of drainage
3. administer stool softener to prevent bearing down
4. acetaminophen
5. diminished neurological status
6. verbal; motor; eye
7. change in LOC
8. phenytoin
9. use IV tubing with filter
10. fluid overload
11. 1.3
12. PO2 of 95 and PCO2 of 35
13. exhibits no symptoms of increased ICP
14. it is possible I may have to share some of what you tell me
15. has the client authorized the release of information
16. notify the hcp of jeff's symptoms
17. rash
18. risk for injury
19. monitor; educate
20. the adolescent has a strong sense of peer group identity
21. you are worried about how your friends will react to you
22. i may have some long-lasting effects from this injury
23. designate a safe driver who will not drink