INTRODUCTION:

Traumatic Brain Injury (TBI) is the result of an external mechanical force applied
to the cranium and the intracranial contents leading to temporary or permanent
impairments, functional disability or psychosocial maladjustment with an associated
diminished or altered state of consciousness. A TBI is caused by a bump, blow or jolt to
the head or penetrating head injury that disrupts the normal function of the brain. The
most frequent causes of TBI are related to motor vehicle accidents, falls, sports, abuse,
and assault. The severity of TBI may range from mild to severe. The tibia is the second
longest bone of the skeleton, located at the medial side of the leg. It is also called the
shin bone. The tibia is fractured more frequently than any other long bone. Bone
fracture, a break in the continuity of bone. A fracture is present when there is loss of
continuity in the substance of a bone. It is a soft tissue injury that is accompanied by a
complete or incomplete break in bone, resulting usually from trauma and/or pathological
considerations. (emedicine.medscape). In 2010, about 2.5 million emergency
department visits, hospitalizations or deaths were associated with TBI, either alone or
combination with other injuries in the U.S (Center for Disease and Control-CDC). On
adults, the incidence of TBI refers to the number of new cases identified in a specific
time period. Every year at least 1.7 occur in the U.S and they are contributing factor in
about (30.5%) of all injury related deaths

PURPOSE OF THE STUDY:

Choosing the case is indeed a challenge for the group. Aside from its complexity,
it is our first time to encounter such case. However, with the available time that we have
given for this study, we know that we have learned much more we have more than we
have expected. From the study of patients pathogenesis, actualizing the clinical
presentations until weighing the possible nursing care interventions, we surely have not
wasted the opportunity to improve our clinical skills. The purpose of the study is to
educate and empower caregivers, patients as well as survivors of traumatic brain injury.
This study would also equip the group with knowledge, skills and attitude on how to
manage patients with traumatic brain injury with fracture on left tibia. The student nurses
will be able to formulate a plan of care and identify nursing responsibilities as well as the
people will be able to understand awareness of the disease, know the possible causes
of the disease and have knowledge of the risk and possible complications of the
disease.
METHODS:
Data were gathered from medical records and/or patients charts, health care
team, interviews with patient and significant others. After data gathering, student nurses
were able to identify potential, actual and spiritual problems and implemented nursing
management. Lastly, student nurses were able to evaluate patients condition. We,
student nurses will present the case that includes essential concepts in relation to the
said condition such as the patients profile and health history, nursing assessment and
clinical manifestations, drug study and diagnostic exams done. The medical and nursing
management and other relevant data are also being covered.
SCOPE:
This case study tackles about Traumatic Brain Injury with complete and displaced
fracture on left tibia. The scope of the plan and assessment encompasses during the
course of duty last February 20-23, 2017. Data gathering about the diagnostic tests
were based on the tests performed with results during our exposure in the area.
RESULT:
The student nurses were able to obtain the baseline data of our client which will
be used for this study. We as a team had a good nurse-client communication. We,
healthcare team as well as families gained a better understanding on how to provide
comprehensive care with TBI through a review of scientific findings and through
practical guidance.

CONCLUSIONS:
The care of traumatic brain injuries is challenging and dynamic. Our case shows
that severe caution should be taken when using prior studies to make medical decisions
about individual patients. Treatment of traumatic brain injuries is complex and should
continue to evolve with evidence-based medicine. Healthcare team will have the
potential to influence not only the well-being of their own patients but also their peers
and local educational system regarding delivery of services.
RECOMMENDATIONS:

The patient is recommended to follow therapeutic regimen and maintain good

fixator or traction care. Most patients are discharged from the hospital when their
condition has stabilized and they no longer require intensive care. A social worker will
work closely with the family as preparations are made for a return home or for transfer
to a long-term care or rehabilitation center. A rehabilitation facility is a place for patients
who do not require a ventilator but who still require help with basic daily activities.
Physical and occupational therapists work with patients to help them achieve their
maximum potential for recovery. A speech therapist helps patients by monitoring their
ability to safely swallow food and helping with communication and cognition. A
neuropsychologist helps patients relearn cognitive functions and develop compensation
skills to cope with memory, thinking, and emotional needs.