8. What complications should the nurse anticipate with subarachnoid hemorrhage?
Question
What complications should the nurse anticipate with subarachnoid hemorrhage?
Solution
Subarachnoid hemorrhage (SAH) is a serious, life-threatening type of stroke caused by bleeding into the space surrounding the brain. If a patient has a subarachnoid hemorrhage, a nurse should anticipate the following complications:
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Rebleeding: This is one of the most serious complications of SAH. It can occur within the first 24 hours after the initial hemorrhage and can lead to further brain damage and neurological deterioration.
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Vasospasm: This is a condition in which the blood vessels in the brain contract and limit blood flow to certain areas of the brain. This can lead to delayed cerebral ischemia, which can cause further brain damage and neurological deficits.
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Hydrocephalus: This is a buildup of cerebrospinal fluid in the brain, which can increase pressure within the skull and cause further brain damage. This can occur as a result of blockage of cerebrospinal fluid pathways due to the initial hemorrhage.
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Seizures: These can occur as a result of irritation to the brain from the initial hemorrhage or from the blood breakdown products.
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Hyponatremia: This is a condition characterized by low sodium levels in the blood, which can occur as a result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or cerebral salt wasting syndrome, both of which can occur after SAH.
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Cardiac complications: These can include arrhythmias, myocardial infarction, or sudden cardiac death, which can occur as a result of the massive release of catecholamines (stress hormones) following SAH.
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Pulmonary complications: These can include pneumonia or pulmonary edema, which can occur as a result of immobility or neurogenic pulmonary edema following SAH.
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Psychological complications: These can include depression, anxiety, or post-traumatic stress disorder, which can occur as a result of the traumatic nature of the event and the subsequent recovery process.
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Neurological deficits: These can include cognitive impairment, speech and language difficulties, and physical disabilities, which can occur as a result of brain damage from the initial hemorrhage or from any of the above complications.
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