Management of Care Q 6
A 70-year-old alcoholic patient with acute lethargy, confusion, and incontinence is admitted to the hospital ED. His wife tells you that he fell down the stairs about a month ago, but “he didn’t have a scratch afterward.” She feels that he has become gradually less active and sleepier over the last 10 days or so. Which of the following collaborative interventions will you implement first?
A. Place on the hospital alcohol withdrawal protocol.
B. Transfer to radiology for a CT scan.
C. Insert a retention catheter to straight drainage.
D. Give phenytoin (Dilantin) 100 mg PO.
Correct Answer: B. Transfer to radiology for a CT scan.
The patient’s history and assessment data indicate that he may have a chronic subdural hematoma. The priority goal is to obtain a rapid diagnosis and send the patient to surgery to have the hematoma evacuated.
Option A: This can be done after the treatment for any intracranial lesion has been implemented.
Option C: This intervention should be done but is not the priority.
Option D: Administration of phenytoin should be implemented as soon as possible, but the initial nursing activities should be directed toward treatment of any intracranial lesion.