Scenario: Cooper Madison, a 6-year-old Caucasian male, arrived atthe emergency department at 1045

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Scenario: Cooper Madison, a 6-year-old Caucasian male, arrived atthe emergency department at 1045 Tuesday with a closed head injury and concussion, related to a fall from a tree house. A CT scan indicated possible skull fracture and subdural hematoma. A C-spine ruled out spinal fracture. While still in the emergency department, Cooper experienced an unwitnessed seizure. At 1300 Tuesday, Cooper was admitted to the pediatric unit. The scenariotakes place on Wednesday at 0645.

Questions to answer from the scenario:

1. What system alterations should the nurse anticipate in the client with closed head injury/concussion? (This would include acid-

base imbalance, respiratory system (oxygenation, ventilation), gastrointestinal, neurological, etc.)

2. What are some potential and actual complications of this client’s current condition?

3. Based on the assessment findings (please list), what nursing interventions are a priority for this client and why? (Please provide

rationale for interventions).

 
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