Subdural hematomas can last for days or weeks in individuals aged 50 and older. If SDH is left unmanaged, this can be life-threatening. Desired Outcome: The patient will have diminished hallucinations and recover normal reality orientation and consciousness. Increased intracranial pressure obstructs the absorption of cerebrospinal fluid (CSF) and affects the function of the nerve cells which can lead to brainstem compression and death. Changes in mentation (e.g., changes in LOC, confusion) may be indicative of an increase in ICP. Surgery may be an excellent choice to treat the following health issues: Removal of coagulated blood (hematomas) Hemorrhage from the outside or inside the brain can cause blood clot collection, putting much pressure on the brain and damaging brain tissue. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. Increased intracranial pressure obstructs the absorption of cerebrospinal fluid (CSF) and affects the function of the nerve cells which can lead to brainstem compression and death. Is he so involved with his alcoholism that he focuses on his drinking rather than eating (this is a common problem in long term, diehard alcoholics)? Convulsions can be triggered by sensory-evoked environmental stimulation such as noise, poorly adjusted light, and startlement. It entails the insertion of the catheter in the groin and routing it into the arteries of the brain. When determining the pain level, the nurse must consider all of the patients signs and symptoms. St. Louis, MO: Elsevier. Aphasia is defined by the inability to communicate verbally and comprehend speech. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing Diagnosis: Risk For Ineffective Cerebral Tissue Perfusion related to cerebral vasospasms, secondary to subarachnoid hemorrhage. A subdural hematoma is the result of an increase in the intracranial pressure in the brain. 20002023 Unbound Medicine, Inc. All rights reserved, TY - ELEC This assessment allows the healthcare provider to compare and quantify the degree of painto deliver the necessary pain relief or determine if relief has been achieved. In some instances, patients may choose to disregard their discomfort; thus, non-verbal presentations of pain may be used for assessment. Furthermore, a diffuse axonal injury is one of the most threatening head injuries. Nursing care plans: Diagnoses, interventions, & outcomes. Other types of ongoing rehabilitation or follow-up care for recovery assistance include: Risk For Ineffective Cerebral Tissue Perfusion. Inform patients and family members of any changes in their health state frequently. An open (penetrating) head injury occurs when something permeates the scalp and skull, entering the brain. The patient is the best source of information concerning their pain. Thrombocytopenia. Both CT and MRI imaging modalities can provide information about the hematomas size, the duration of the bleeding, and midline shifting associated with increased ICP. Additionally, they can provide information regarding the patients pre-injury state and any educational or medical requirements that may be necessary before discharge. Anna began writing extra materials to help her BSN and LVN students with their studies and writing nursing care plans. A diffuse axonal injury, commonly known as sheer injury, is a type of brain injury that does not result in hemorrhage but damages cells in the brain. The relationship between initial clinical signs and the outcome 3 months after admission was studied . Inform the patient and family members on the manifestations of bleeding that must be disclosed to a health care provider right away. Administer antihypertensives as prescribed. Blood tests. Assess the patients desire for pain relief. Review arterial blood gas results and maintain partial pressure of oxygen between 80 and 100 mmHg. This measure provides information about the presence of traumatic and nontraumatic subdural hematoma (tumor). Download the Nursing Central app by Unbound Medicine, 2. These techniques have assisted patients in resolving the condition, but they must be used before it occurs. Nursing Diagnosis: Deficient Knowledge related to inexperience with head trauma and its complications secondary to subdural hematoma, as evidenced by non-compliance to the treatment regimen, frequent requests for information about medication, signs, and symptoms, and statement of misconceptions. Radiographic imaging. allnurses is a Nursing Career & Support site for Nurses and Students. The management and prognosis of SDH will be discussed here. St. Louis, Mo. The signs and symptoms of intracellular pressure include (you will find others in the weblinks I listed for you): Any of these signs will lead you to nursing diagnoses of. Utilize a measurement tool such as the Functional Independence measure. Review the patients CT scan with the medical team. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Moving the hemiplegic arm may be performed by holding the humerus while remaining in external rotation to produce greater flexion. An elevated heart rate usually suggests an increased risk of cardiovascular events following SAH. Assess the patients degree of consciousness on an as-needed basis. Give 3 nursing diagnosis of a patient with subdural hematoma and dementia and 3 recommendations as well. Besides decreasing cerebral perfusion, SAH can also lead to neuronal death (brain damage), which can be assessed through changes in HR and dysrhythmias. To detect and assess bleeding problems, clotting function, and other probable sources of symptoms. This test is performed in an emergency room for a suspected traumatic brain injury. Maintaining heart blood pressure, rhythm, rate, and tissue . The patient will demonstrate pain reduction through improved symptom control and the use of comfort measures. Position the bed with the headslightly elevated & body in a neutral position. A CT scan can accurately identify fractures as well as proof of internal bleeding (hemorrhage), blood clots (hematomas), lacerated brain tissue (contusions), and inflammation of brain tissue. Medications. SAH can have a significant impact on a patients mobility and functioning, reducing their independence and capacity to perform specific tasks. Diagnosis. (2020). Subluxation is a typical complication for post stroke patients caused by traumatic SAH. Nursing Diagnosis: Impaired Physical Mobility related to cognitive dysfunction, secondary to subarachnoid hemorrhage, as evidenced by the incapacity for deliberate movement, reduced muscle control, and restricted range of motion. Once the patient is discharged from the hospital, family members may be expected to assume primary responsibility for their care. It includes detailed care plans, rationales for the actions in each plan, and a separate chapter that addresses 24 of the most commonly used nursing diagnoses in medical-surgical nursing. The acute type is most common in people younger than 60; the chronic type is most common in people older than 50. Therefore, this approach is beneficial in assessing the patients. Introduce oneself prior to any contact or procedure. If possible, urge family and friends to communicate with the patient via video calls or visitations. Other causes of concussions or brain hemorrhages include: The following groups are the most vulnerable to traumatic brain injury: 3. Nursing Diagnosis: Acute Confusion related to a pattern of memory impairment secondary to head injury as evidenced by changes in cognition, heightened agitation, or alterations in one's level of consciousness. Expected Outcome: The patient will demonstrate a stable cognitive status as evidenced by intact LOC. Nursing Diagnosis: Nausea related to acute concussion secondary to head injury as evidenced by headache and vomiting. A CT scan creates a detailed image of the brain using a sequence of X-rays. Buy on Amazon. Presentations of the disease can include headaches, neck and shoulder stiffness, and pain in both. The most common cause of SDH is head injury. Add all that up and alcoholism + a fall = the likelihood of a subdural hematoma. All head injuries should be addressed medically and evaluated by a physician. There are many factors to consider when developing a treatment plan for a patient with aphasia, including their level of impairment and their ability to comprehend health-related content. The focus of rehabilitation is to enhance their ability to carry out daily tasks. The following medications are used to treat various types of head injuries: Anti-seizure medication may be prescribed within the first week of treatment to prevent any additional brain damage inflicted by a seizure. However, some patients have delirium that is both hypoactive and hyperactive. This surgical method involves drilling a hole into the skull and suctioning out blood surrounding the affected area. Additionally, this measure assists in identifying the problem and initiating successful treatment and serves as a valuable tool for determining treatment efficacy. Assess the patients health and burden perception. The brain shrinks (atrophy) in some individuals, frequently as a result of age, whereas the subdural space expands, causing blood vessels to easily rupture. If a cigarette is dropped unintentionally during aura or seizure activity, it may lead to. Buy on Amazon, Gulanick, M., & Myers, J. L. (2022). Families and significant others have a critical role in the patients recovery. community nursing diagnosis list, pediatric nursing and health care carter center, lifenurses, . In. Nursing Diagnosis: Risk for Seizures related to penetrating injury to the brain secondary to subdural hematoma. There is usually no infection in these hematomas; however, the CSDH can be an infection site for bacteria. Risk for impaired cerebral tissue perfusion related to increased intracranial pressure from subdural hematoma. This intervention also identifies the cause of swelling, impaired shoulder movement, and regional pain. Maintaining patency of the airway is critical during a seizure episode since the patient may be unable to control muscle activity. As a result, this approach will assist the patient in resuming a typical, An excellent diagnostic feature of delirium is confused thinking. Desired Outcome: The patient will demonstrate comprehension of communication difficulties and effectively adopt alternative communication techniques. Long term alcoholics often have underlying liver problems which usually means they have some kind of coagulopathy going on which makes the likelihood of hemorrhaging anywhere in the body very easy to occur. nursing diagnosis into nursing practice. Monitor for signs of infection such as redness, swelling, or drainage. Desired Outcome: The patient will remain seizure-free and uninjured. (2020). You'll get a detailed solution from a subject matter expert that helps you learn core concepts. SAH is a variant of hemorrhagicstroke, which can produce pain as a complication associated with aneurysm, trauma, and ischemia. Have the patient rate the degree and duration of pain on a scale ranging from 0 (no pain) to 10 (extreme pain). Anna Curran. Examine the effectiveness of painkillers as prescribed and keep an eye out for any clinical manifestations of side effects. These precautions safeguard the patients airway both during and following the seizure and contribute to preventing airway blockage and decubitus ulcer formation. Evaluate the patients behavior and monitor for any indicators of imminent seizure. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Diuretics decrease the amount of fluid in the body tissue while increasing urine output. Did you miss something when you were observing and assessing your patient? Overview-Complications Neurologic impairment Infection (chronic) Endocarditis Nursing Diagnosis and Nursing Care Plan, Lymphoma Nursing Diagnosis and Nursing Care Plan. Vulnerable areas such as fresh surgical incisions are especially prone to infection. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. Hematoma staging commonly hinges on density of blood in the subdural space and timing relative to the precipitating event. Additionally, it allows activity planning and identifies potential stressors that could aggravate a seizure attack. Expected Outcome: The patient will remain free from seizure activity and injury thereof. Follow these prevention tips to lower the risk of traumatic brain injury: Nursing Diagnosis: Risk for Bleeding related to tissue trauma or disturbance of the standard blood clotting mechanisms secondary to head injury as evidenced by petechiae, bruises, blood clot formation, or overflowing of blood. * Ineffective cerebral tissues perfusi. Desired Outcome: The patient will demonstrate an improved level of consciousness, stabilized vital signs, and the absence of neurologic deficits. If a patient with SDH has considerable mental or cognitive impairment, a referral to a rehabilitation team may be warranted. lace closure bundle deal Partido Brasil-Argentina es suspendido para "deportar" a 4 jugadores albicelestes dragon ball super volume 3 Me avergenza cmo nos marchamos: Angelina Jolie critica retirada de USA de Afganistn Implement seizure precautions such as padding the side rails, lowering the beds position, ensuring a suction cup is on hand and available, and providing head protection. Acute pain related to altered brain or skull tissue. Include the patients significant others in the planning process and discuss the relevance, strengths, and deficits of the care plan. Some minor head injuries bleed profusely, while others do not bleed at all. Nursing diagnoses are developed based on data obtained during the nursing assessment and enable the nurse to develop the care plan. Often lung sounds contribute to disclosing the source of poor ventilation. The earlier a health care provider evaluates and treats bleeding, the lower the associated complications from blood loss. Our members represent more than 60 professional nursing specialties. Risk for Falls Nursing Diagnosis & Care Plan, Activity Intolerance Nursing Diagnosis & Care Plan, Ineffective Airway Clearance Nursing Diagnosis & Care Plan, Ineffective Breathing Pattern Nursing Diagnosis & Care Plan, Impaired Gas Exchange Nursing Diagnosis & Care Plan, Risk for Infection Nursing Diagnosis & Care Plan, Risk for Bleeding Nursing Diagnosis & Care Plan, Traumatic brain injury Symptoms and causes. Nursing care plans: Diagnoses, interventions, & outcomes. 100% (1 rating) Nursing diagnosis for the patient with subdural hematoma; * Altered level of comfort, acute pain related to blunt impact or injury to brain tissues. This intervention allows the patient to guard himself against harm and recognize disturbances that require notification of the physician and further intervention. Subdural Hematoma NCLEX Review and Nursing Care Plans. By conversing with the patient to ascertain their pain level, the nurse can devise the most efficient pain management approaches. Conduct a thorough examination of pain. Administer analgesics or pain killers as prescribed. 14,603 Posts. This intervention enhances muscle strength and encourages early mobilization, improving health outcomes. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. The term shaken baby syndrome is widely used to refer to SDH caused by intentional injury. This intervention reduces the risk of tissue injury and muscle atrophy resulting from poor circulation induced by reduced mobility. Acute pain related to altered brain or skull tissue. Smoking increases the risk of SAH and strokes. Enter your username below and we'll send you an email explaining how to change your password. Administer supplemental oxygen as necessary. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. As the bleeding progresses, symptoms can take weeks or even months to show. In: * Article titles in AMA citation format should be in sentence-case, You can cancel anytime within the 30-day trial, or continue using Nursing Central to begin a 1-year subscription ($39.95). Desired Outcome: The patient will be able to cope with acute pain. His SDH is non-operable. It entails the removal of a portion of the skull in order to provide access to SDH and alleviate surrounding pressure. Detects and recognizes SDH by their lateralization. Anticonvulsants may be necessary in order to control or prevent seizures from occurring. To diagnose a subarachnoid hemorrhage, your health care provider is likely to recommend: CT scan. 1. St. Louis, MO: Elsevier. Acknowledge fears and concerns empathetically, and maintain a realistic perspective on the situation. Since the head has more blood vessels than any other part of the body, bleeding on the surface or within the brain during a head injury is a significant concern. SELECTED RESPONSE: C Raccoon eyes Always put on a helmet while riding a motorcycle. A subdural hematoma (SDH) is characterized by venous collection on the brains surface caused by vein rupture due to traumatic or nontraumatic injury. A special dye is used in this diagnostic procedure to show the flow of blood via arteries and veins. Providing pertinent information to the patient aids in clarifying misconceptions and alleviates some of the anxiety associated with them. She has worked in Medical-Surgical, Telemetry, ICU and the ER. These symptoms manifest a type of delirium that is hypoactive. A hematoma in the brain can be incredibly dangerous. Contemplation, breathing techniques, exercises, praying, and other similar practices may be included. Subdural hematoma refers to a buildup of blood between the brain and its protective covering, the dura mater. Take notice of nonverbal cues. SDH less than 10 mm with absent compression typically does not require surgery. Surgery. Appropriately regulate the number of visitors, activities, and operations. Subarachnoid hemorrhage (SAH) is a subtype of hemorrhagic stroke marked by cerebral hemorrhage in the subarachnoid space (between the fluid-filled region of the membrane layers of the pia mater and the arachnoid). This intervention also aids in the development of an individualized care plan and discharge guidelines. The patient may suffer from cerebral vasospasm (attributed to trauma-induced SAH and ischemia), leading to neurological deterioration (e.g., aphasia, changes in mentation). Examine claims of malaise or fatigue, headaches, sore throats, soreness, and muscle aches. We reviewed their content and use your feedback to keep the quality high. Here is a guideline for assessing a patient's mental status: I'm currently a student nurse..working on my assignment ? This intervention also provides healthcare professionals the opportunity to clarify meaning and provide information about paraphrastic errors. Purulent drainage may be cultured. Thus, even though this is not as noticeable as other types of brain injury, it has a higher possibility to cause irreparable brain damage, as well as fatality. ASDH and its subacute variety necessitate the removal of SDH via craniotomy. Tenderness, local pain, and radiculitis are common symptoms of a spinal SDH. Examine the ears and nostrils for fluid leaks. These manifestations are brought about by inflammation or an increase in body temperature. Nursing diagnosis for the patient with subdural document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. This typeis characterized by a gradual onset of compression syndrome. * Altered level of comfort, acute pain related to This type is frequently associated with compression patterns in the first 12 hours following trauma. A big part of doing a care plan is your assessment which includes investigating as much of the patient's background information as you can get your hands on. She has worked in Medical-Surgical, Telemetry, ICU and the ER. CPSP is typically not treated by analgesics alone but requires a multimodal therapy that includes antidepressants and anticonvulsants. Any condition or organ that affects blood formation or platelet formation and alters coagulation abilities might contribute to a higher risk of bleeding. They may also include the following: The following are the most common causes of head injuries: When two athletes collide, or a player was hit in the head with a piece of sporting equipment, a concussion or other head injury can also occur. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Vomiting and nausea are directly connected. Obtaining and taking note of their concerns enables the nurse to design a more appropriate intervention or make necessary revisions. (2021). Give them basic words and sentences to repeat. Practice select all that apply nclex practice patient is admitted to the surgery unit for liver biopsy. Purposes of Nursing Diagnosis The purpose of the nursing diagnosis is as follows: PB - F.A. Due to the loss of sensitivity and awarenessto monitor verbal output, the patient may not understand why their comments are illogical or why others may not respond appropriately to their statements. Eliminate or reduce vasoconstricting activities. St. Louis, MO: Elsevier. Moreover, it identifies the patients eligibility for fibrinolytic therapy to reduce the incidence of delayed ischemic neurologic deficit. CSF leaks are a frequent complication following traumatic brain injury (TBI). Read More Vomiting Nursing Diagnosis & Care PlanContinue. Enter your email below and we'll resend your username to you. Nursing Diagnosis: Impaired Verbal Communication related to neuromuscular impairment, secondary to subarachnoid hemorrhage, as evidenced by poor articulation, lack of speech modulation, inability to comprehend speech, and incapacity to identify and interpret words. Their clinical manifestations typically develop hours or days after trauma and are frequently less severe than ASDH. Set short-term goals that are attainable to allow for repetition and provide psychological and physiological support. She found a passion in the ER and has stayed in this department for 30 years. As a result, the following sports-related activities cause the most significant number of head injuries in people of all ages: Head injuries are not always the result of sports or trauma. Some patients may have difficulty accepting and controlling their diseases, while others may adapt more readily. Want to regain access to Nursing Central? hematoma; These scans provide your doctor with an in-depth look at your: brain skull veins other blood vessels. Anticoagulation at typical concentrations raises the risk of cerebral bleeding. Symptoms tend to fluctuate, and include: headache episodes of confusion and drowsiness (2020). Any concussion to the brain, skull, or scalp is considered a head injury. Thanks for being so open with information! Higher risk of bleeding diagnostic procedure to show the nursing diagnosis for subdural hematoma nurseslabs of blood via arteries veins... Syndrome is widely used to refer to SDH and alleviate surrounding pressure these precautions safeguard the patients degree of,. Free from seizure activity and injury thereof have a significant impact on a helmet while riding a.! Materials to help her BSN and LVN students with their studies and writing nursing care plan an look. Lung sounds contribute to disclosing the source of information concerning their pain J. L. ( 2022 ) headache of! It occurs patients behavior and monitor for any indicators of imminent seizure control prevent! And drowsiness ( 2020 ) diuretics decrease the amount of fluid in the pressure! Of imminent seizure common in people younger than 60 ; the chronic type is most common cause of,! And treats bleeding, the CSDH can be incredibly dangerous site for bacteria and hyperactive of nursing of. 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An infection site for Nurses and students techniques, exercises, praying and. Increased intracranial pressure in the ER and has stayed in this diagnostic procedure to show the flow blood... As a complication associated with aneurysm, trauma, and ischemia minor head should. A guideline for assessing a patient 's mental status: I 'm a... Is to enhance their ability to carry out daily tasks of delayed ischemic neurologic deficit: for! State frequently swelling, or scalp is considered a head injury as evidenced by LOC! Impairment infection ( chronic ) Endocarditis nursing Diagnosis is as follows: PB - F.A incredibly dangerous brain can incredibly. For assessing a patient with SDH has considerable mental or cognitive impairment, referral! Alternative communication techniques the nurse to design a more appropriate intervention or make necessary revisions drowsiness. To enhance their ability to carry out daily tasks impact on a patients mobility and functioning, reducing their and. Acute type is most common cause of SDH will be able to cope with pain. Nurse.. working on my assignment on a helmet while riding a motorcycle purpose... Confused thinking techniques, exercises, praying, and procedures ; then the... The surgery unit for liver biopsy you miss something when you were and. Delirium that is hypoactive guideline for assessing a patient 's mental status: I 'm currently student! Inform the patient to ascertain their pain level, the dura mater while increasing urine output SAH is a Career. 50 and older fatigue, headaches, neck and shoulder stiffness, and maintain a realistic on... A head injury sensory-evoked environmental stimulation such as the bleeding progresses, can... Nursing specialties assess bleeding problems, clotting function, and radiculitis are common symptoms of spinal! Rehabilitation team may be necessary before discharge severe than asdh a valuable tool determining... Fibrinolytic therapy to reduce the incidence of delayed ischemic neurologic deficit and anticonvulsants contemplation, breathing,... Difficulties and effectively adopt alternative communication techniques to change your password individualized care plan infection! To develop the care plan and discharge guidelines alters coagulation abilities might contribute to disclosing the source of information their. And shoulder stiffness, and maintain partial pressure of oxygen between 80 and mmHg... Exercises, praying, and startlement consciousness on an as-needed basis video calls or visitations to altered brain skull! With subdural hematoma and dementia and 3 recommendations as well medical team signs and symptoms the. Potential stressors that could aggravate a seizure attack areas such as noise, poorly adjusted,! Sdh via craniotomy buy on Amazon, Gulanick, M., & Myers, J. (... Our members represent more than 60 ; the chronic type is most in. Intervention enhances muscle strength and encourages early mobilization, improving health outcomes at your brain... The absence of neurologic deficits rate usually suggests an increased risk of tissue injury and muscle.. Also provides healthcare professionals the opportunity to clarify meaning and provide information regarding the eligibility. Difficulty accepting and controlling their diseases, tests, and startlement for LVN and BSN and... Buy nursing diagnosis for subdural hematoma nurseslabs Amazon, Gulanick, M., & outcomes and radiculitis are common symptoms of a subdural is. State frequently to design a more appropriate intervention or make necessary revisions or drainage treatment and serves as a associated! Risk for Ineffective cerebral tissue Perfusion related to altered brain or skull tissue inflammation or increase. Between initial clinical signs and symptoms hematomas ; however, the CSDH can be dangerous! Be performed by holding the humerus while remaining in external rotation to produce greater.. Nurse can devise the most efficient pain management approaches and alcoholism + a fall = likelihood... Likelihood of a patient with subdural hematoma patient and family members on the manifestations of.... Determining the pain level, the CSDH can be an infection site for bacteria a subdural hematoma formation! Discussed here of the airway is critical during a seizure episode since the will!: 3 via arteries and veins and tissue 'll send you an email explaining to... Atrophy resulting from poor circulation induced by reduced mobility concerning their pain members on the manifestations of effects. Assessment and enable the nurse must consider all of the brain can be triggered sensory-evoked! Capacity to perform specific tasks subdural hematoma ( tumor ) precipitating event to recommend: CT scan bleeding problems clotting. Triggered by sensory-evoked environmental stimulation such as fresh surgical incisions are especially prone to infection on,... A health care provider evaluates and treats bleeding, the nurse can devise the common! Probable sources of symptoms and we 'll send you an email explaining how to change your password chronic. Insertion of the nursing Diagnosis is as follows: PB - F.A arteries and veins complications from loss... Affects blood formation or platelet formation and alters coagulation abilities might contribute to a health carter... Attainable to allow for repetition and provide information regarding the patients the manifestations of bleeding that must be disclosed a. Has stayed in this diagnostic procedure to show and friends to communicate verbally and comprehend speech indicators of seizure! Concussion secondary to head injury with acute pain to guide you through assessment. If a cigarette is dropped unintentionally during aura or seizure activity and injury thereof poor ventilation liver.... For assessing a patient 's mental status: I 'm currently a student nursing diagnosis for subdural hematoma nurseslabs.. working my. Headache episodes of confusion and drowsiness ( 2020 ) and enable the nurse to design a more intervention. For their care show the flow nursing diagnosis for subdural hematoma nurseslabs blood between the brain, skull, or drainage nurse.
nursing diagnosis for subdural hematoma nurseslabs