Discharge And Home Healthcare Guidelines

Teach postoperative care to patients who have had surgery. Teach the patient how to plan a paced progression of activities. Teach the patient the dosages, routes, and side effects for all medications. Review drug and food interactions with the patient. Instruct the patient to report bowel elimination problems to the physician. Emphasize that, in the case of recurrent abdominal pain, fever, or vomiting, the patient should go to the emergency department for evaluation.

Intracerebral Hematoma

DRG Category: 014

Mean LOS: 6.4 days

Description: MEDICAL: Specific Cerebrovascular

Disorders Except TIA DRG Category: 002 Mean LOS: 9.8 days Description: SURGICAL: Craniotomy for Trauma, Age > 17

^An intracerebral hematoma (ICH) is a well-defined collection of blood within the brain parenchyma (functional tissue). Most ICHs are related to cerebral contusions; ICHs complicate head injury in 2% to 3% of all head-injured patients. Although they are more frequently associated with closed-head injuries, they can also occur as a result of an open or penetrating injury or a depressed skull fracture. Similar to cerebral contusions, ICHs tend to occur most commonly in the frontal and temporal lobes and are uncommon in the cerebellum. They can also occur deep within the hemispheres in the paraventricular, medial, or paracentral areas in association with the shearing strain on small vessels that occurs with diffuse axonal injuries.

The patient can experience deterioration in cerebral functioning at the time of injury or in the first 48 to 72 hours after injury. Late hemorrhage into a contused area is possible as long as 7 to 10 days after injury. ICHs result in a mortality rate between 25% and 72%. Complications include intracranial hypertension, brain herniation, and death.

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