After S.B. stabilizes from this the brief episode of increased intracranial pressure (ICP), he stays in the
hospital for 72 hours, during which time his condition remains relatively stable.
Before discharge, bilat
eral short arm casts are applied. Arrangements have been made for him to go to his family home for
recuperation.
As you are evaluating discharge teaching for S.B., you would understand that further
teaching would be required if he stated:
a. "I will try to avoid blowing my nose for the next 2 weeks."
b. "If I start vomiting, I will return to the hospital immediately."
c. "If I do not move my bowels each day, I will take a Dulcolax."
d. "Because a headache is expected, I can take aspirin for the pain."
d
The use of aspirin and aspirin derivatives is contraindicated because of the increased risk of
bleeding associated with their use; acetaminophen is a better choice for pain management. The
patient would be instructed to refrain from blowing his nose because this will lessen the pressure
on brain tissue and decrease the likelihood of worsening the tear. He would be instructed to take
a Dulcolax if he does not move his bowels daily for the same reason. The onset of vomiting might
indicate an increase in ICP, possibly from further bleeding at the site of the injury.
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