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Intacranial Pressure
Intracranial Pressure
| Question | Answer |
|---|---|
| Name five causes of increased ICP | traumatic brain injuries, brain tumors, meningitis, encephalitis, brain abscesses, hydrocephalus, infection, birth trauma |
| Name 8 signs of increasing ICP | severe headache, deteriorating level of consciousness, restlessness, irritability dilated or pinpoint pupils slow to react/nonreactive, alteration in breathing pattern (cheyne stokes, hyperentilation, apnea) Deterioration in motor function, abnormal apnea |
| What are the characteristics of Cushing Reflex? | Severe HTN, Bradycardia, Widening Pulse Pressure (between systolic and ditolic) |
| Name two medications usef for the medical management of ICP | Mannitol - Osmotic Diuretic reduces edema through diuresis; Monitor urinary output Decadron - Corticosteroid reduces inflammation; Monitor blood glucose levels; Often accompanied by a proton-pump inhibotor or H2 Blocker Sedatives:Benzodiazepines |
| Name 6 common everyday activiteis that could increase ICP | Coughing, suctioning, blowing nose forcefully, extreme neck of hip flexion, head of the be less than 30 degrees, increased intra abdominal pressure |
| Name 2 things you can do when suctioning to maintain airway patency | When suctioning hyper oxygenate with 100% oxygen Limit thenumber of passes and <10 sconds each pass |
| What can the nurse do to decrease the chances of infection post craniotomy for ICP line pacement | aseptic technique, sterile dressing changes per facility protocol, keep draininage system closed; irrigate only as needed to main patency, limit monitoring for 3-5 days |
| What is the Glasgow score for patient -eye opening to pain -Incomprehensible sounds -Withdrawal from Pain | Eye opening to pain = 2 incomprehensible sounds = 2 withdrawal from pain = 4 |
| Brain tissue weighs? | 1400 g or 3 pounds |
| cerebrospinal fluid weighs | 75 cc or 2.5 oz |
| what is normal intracranial pressure | 10-15 mm hg |
| What pressure requires immediate medical intervention? | pressures > 20 mm |
| What are some Increased Intracranial Pressure Clinical Manifestions | Severe Headache Deteriorating Level Of Consciousness Restlessness Irriability Dilated or pinpoint pupils slow to react/nonreactive Altered Breathing Pattern Cushing Reflex |
| Cushing Reflex is a Late sign of | ICP |
| What are signs of Cushing Reflex which is a late sign of ICP? | Severe HTN Bradycardia Widening Pulse Prssure |
| Decerbrate indicates what? | Upper Brain Stem Damage |
| Decorticate | Damage to the Corticospinal tract, the pathway between the brain and the spinal cord |
| What are four methods of ICP monitoring? | Intraventricular Subarachnoid Epidural or Subdural sensor Intraparencymal |
| What are some complications of Craniotomy/Placement of ICP Line? | Infection, hemorrhage, fluid and electrolyte imbalance, CSF leak, DVT, Gastric Ulcers, pneumonia, diabetes insipidus, SIADH ( Syndrome of inappropriate Antidiuretic Hormone) |
| What is a criteria for ICP Monitoring? | Clinets who are comatose and or have glasgow Coma score (GCS) of 8 or less |
| Mannitol For ICP | Osmotic diuretic reduces edema through diuresis - Mx Urinary output |
| Decadron for ICP | Corticoseroid reduces inflammation, monitor blood glucose levels. Often accompanied by a proton pump inhibitor or H2 blocker |
| Hypertonic Saline for ICP | Reduce edema by rapid movement of water out of ventricles into blood stream |
| ICP increases with ? | Coughing, suctioning, blowing nose forcefully, extreme neck of hip flexion, head of bed less than 30 degrees |
| In the glasgow Coma scale which is not true? 1. It is always has 15 ponts 2. It measures LOC 3. It is less vali when used by inexperienced users. 4. It is the only scale int he world where you can be dead and still score 3. | 3. It is less valid when used by inexperienced users. |
| A pt is taken 2 surgery 4 placement of an ICP line. His wife is afraid and asks the nurse what is going to happen in surgery. What should the nurse say? | The small area of the scalp will be shaved and then numbed |
| Which nursing diagnosis does this client have upon return from surgery for placement of ICP line? | Risk for infection |
| What nursing interventions should be included in this ct's plan of care to decrease chances of infection post ICP line placement. | perform sterile drsg change keep drainage system closed limit monitoring to 3-5 days irrigate system only as needed to maintain patency |
| A nurse is preparing to vie the patient post craniotomy for ICP line placement, a medication for incisional pain. The family asks why the pt is getting codeine and not something stronger? | Codeine does not alter respiration or mask neurological signs |
| The nurse is positioning the patient with increased ICP? Which position would the nurse avoid? | Head turned to side |
| A nurse determines that the patient understands measures to prevent elevation of ICP if the nurse observes the patient doing the following? | Exhaling during repositioning. |
Created by:
starr8904
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