Essentials of Pathophysiology: Concepts of Altered States
Essentials of Pathophysiology: Concepts of Altered States
4th Edition
ISBN: 9781451190809
Author: Carol Porth RN MSN PhD
Publisher: LIPPINCOTT WILLIAMS+WILKINS
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Chapter 37, Problem 1RE

A.

Summary Introduction

To determine:  The clinical signs of coma

Introduction: The coma is a condition in which the person remains in prolonged unconsciousness. The state can be caused due to traumatic head injury, stroke, brain tumor, drug, or alcohol consumption.

A.

Expert Solution
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Explanation of Solution

Coma may be caused due to traumatic brain injuries, which are caused by traffic collisions, violence, or it may be caused due to: lack of oxygen, infections (encephalitis, meningitis), seizures, and many more. The clinical signs of the coma involve the closing of eyes, depressed brainstem reflexes, pupils not responding to light, no responses of limbs, no response to painful stimuli, followed by irregular breathing.

B.

Summary Introduction

To determine: The areas of the brain involved in a coma.

Introduction: The unconsciousness condition of the body in which the person is unable to react with his surroundings. The coma represents the minimal activity of the brain, and the patient is unable to respond to physical and auditory stimulation.

B.

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The human brain involves three significant parts that are the cerebrum, cerebellum, and the brain stem or medulla. The thalamus is another vital organ for carrying sensory impulses to the cerebral cortex. The consciousness of a person depends on the transmission of the chemical signals from the brain stem to the thalamus, followed by the cerebrum. This neural pathway is known as the Reticular Activating System. If RAS is interrupted, the person may face alteration in consciousness.

C.

Summary Introduction

To determine: The complications of traumatic head injury, which might lead to coma.

Introduction:  the traumatic brain injury is caused when a penetrating injury results in damage to the brain. The TBI leads to disability and mortality in people and is caused by either trauma or complication of the initial injury.

C.

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Explanation of Solution

The TBI is most commonly caused by falls, road accidents, physical assaults, and athletic injuries. The TMI may be followed by various complications such as Alzheimer's disease, cranial nerve injuries, dementia, seizures, hypoxia, brain hemorrhages, and many more are the complication of TBI, which might lead to coma.

D.

Summary Introduction

To determine: The key treatment options to manage elevated intracranial pressure.

Introduction: During a coma or state of unconsciousness, a person is unable to react to external stimuli and normal reflex responses. The coma may be severe or mild, which depends on its cause and extent of damage, and it may last for a few weeks or months in the vegetative state of a coma.

D.

Expert Solution
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Explanation of Solution

The diagnosis of coma may be made by recent history, blood tests, and imaging scans of the brain and helps the doctors to decide the treatment accordingly. The treatment involves the circulation of oxygen in the brain, antibiotics, or administer glucose for blood tests. For the treatment of increased intracranial pressure, doctors may suggest sedation, drainage of CSF, and osmotherapy with hypertonic saline.

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Chapter 37 Solutions

Essentials of Pathophysiology: Concepts of Altered States

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