Which of the following 5 signs might indicate that Angela is developing an intracranial bleed? Select Yes or No for each indicator.
Bruising to the skin – No – bruising of the skin is not an indicator of neurological deterioration; however bruising should be observed closely to ensure this is not an early sign of bleeding.
Onset of drowsiness – Yes – onset of drowsiness may be an indicator of neurological deterioration. Monitor the patient’s Glasgow Coma Scale closely to give a reliable way of determining changes in the patient’s conscious state.
Rising blood pressure and falling pulse – Yes – a rising blood pressure and falling pulse may be an indicator of neurological deterioration in conjunction with changes in the Glasgow Coma Scale and general observations of the patient.
Small epistaxis – No – a small epistaxis is not an indicator of neurological deterioration; however it should be monitored closely and the degree of severity noted.
NIHSS score increase of 4 – Yes – an increase of 4 on the NIHSS score would indicate neurological deterioration. The NIHSS is used as a clinical assessment tool to evaluate neurological status in acute stroke patients.
