You are assigned to Mr. Leonard, a

You are assigned to Mr. Leonard, a 70 year old client diagnosed with meningitis and head injury sustained in a head-on MVA. The client had turned off IH 35 onto a two lane gravel road en route to his lake cabin. He had neglected to re- apply his seatbelt after he stopping to purchase week end supplies and fishing for his cabin for the weekend. He was thrown from the car onto a gravel and partial grass surface at the side of the road. Mr. Leonard hit his head on the dashboard and sustained a head laceration, along with cuts and abrasions to his face, arms, and legs. 911 was called by a passenger in the other vehicle. After a 1 hour delay, Mr. Leonard was taken to the closest hospital Emergency Room. Mr. Leonard was confused and disoriented upon initial assessment by the paramedics. The ED physician ordered a head CT scan and a brain MRI to determine any head trauma had occurred. Both exams revealed negative findings. Mr. Leonard was discharged home after 5 days in the hospital. He was instructed to follow up in one week with his primary care physician or sooner if he developed symptoms. Mr. Leonard began to have severe headaches, nausea and vomiting, blurred vision, and an oral temperature of 103°F (39.4°C). He returned to the Emergency Department, and a diagnosis of meningitis was confirmed. He was admitted and started on IV antibiotics. The next morning, Mr. Leonard states “I felt ok when I left the hospital, what is happening to me?” What comprises a complete and a focused neuro check and how do you perform it? What findings would require immediate action? What action should be taken? The nurse needs to complete the admission forms. When collecting subjective data, what present or past health concerns should the nurse focus on? Why? SCIENCE HEALTH SCIENCE NURSING NURS 3352

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