A 17 year old boy falls off a skateboard and hit his head on a rock wall and is knocked unconscious for ten minutes. Upon awakening he is neurologically intact but does not remember the accident. Several hours later, he develops a headache, vomits and develops right sided weakness. Mother brings him to ER. On exam BP 180/110 HR 50, RR 28 Mental status -- Lethargic but responsive. Motor -- Right hemiparesis. Reflexes bilateral plantar extensor responses (upgoing toes). Cranial nerves- left pupil is 8mm and poorly reactive to light; right pupil is 3 mm. What intervention does he need most urgently?     hyperventilation     IV steroids     IV dextrose, thiamine, naloxone      Drug to lower his BP

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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A 17 year old boy falls off a skateboard and hit his head on a rock wall and is knocked unconscious for ten minutes. Upon awakening he is neurologically intact but does not remember the accident. Several hours later, he develops a headache, vomits and develops right sided weakness. Mother brings him to ER. On exam BP 180/110 HR 50, RR 28 Mental status -- Lethargic but responsive. Motor -- Right hemiparesis. Reflexes bilateral plantar extensor responses (upgoing toes). Cranial nerves- left pupil is 8mm and poorly reactive to light; right pupil is 3 mm. What intervention does he need most urgently?

   

hyperventilation

   

IV steroids

   

IV dextrose, thiamine, naloxone 

   

Drug to lower his BP

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