What should the nurse monitor for in a child with signs of a head injury?

Monitoring the level of consciousness in a child with signs of a head injury is crucial because alterations in consciousness can indicate changes in brain function or presence of increased intracranial pressure. This assessment can help identify the severity of the injury and guide appropriate interventions. A declining level of consciousness may suggest potential complications, such as edema, hematoma, or concussion, requiring immediate medical attention.

Regularly evaluating consciousness levels involves using standardized tools, such as the Glasgow Coma Scale, which assesses eye, verbal, and motor responses. This monitoring should be frequent and include observing for any changes in orientation, responsiveness, and motor skills. The assessment is vital as it provides real-time insights into the child's neurological status and aids in determining the need for further diagnostic testing or interventions.

Other factors, like family history of seizures, presence of skin rashes, or heart rate variability, may be relevant in certain contexts but are less directly associated with the acute assessment and management of head injuries.