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NUR135 Increased ICP
Question | Answer |
---|---|
Signs and symptoms of increased intercranial pressure | Decreased level of consciousness, impaired people Larry characteristics, impaired motor function; hemiparesis, hemiplegia, hypothalamus impairment loss of temperature control, increase systolic blood pressure |
What is normal intercranial pressure | 10 to 15 mm Hg |
What are the three components that adapt throughout the day to maintain normal ICP | Brain, blood, cerebral spinal fluid |
Perfusion pressure of what is incompatible with life | 20mm Hg or less |
Earliest change of seen in ICP | Changes in level of consciousness |
Late signs of increased ICP | Dilated and fixed pupils that no longer react to light |
Motor deficits develop on the side opposite of the expanding mess | Known as contralateral to the injury |
Hemiparesis | Weakness on one side |
Hemiplagia | Paralysis on one side |
Loss of temperature control | Hypothalamic impairment |
What happens to blood pressure with increased intracranial pressure | Systolic blood pressure increases with little or no associated increase in diastolic blood pressure |
More late signs of increased ICP | Changes in pulse, respiratory pattern, and blood pressure |
Interventions to decrease intercranial pressure | Elevate head of bed to 30deg, IV fluids , controlled hyperventilation, mechanical ventilation, ventriculostomy Cather, mannitol, diuretics, corticosteroids |
What should you teach a patient about for ICP | Avoid coughing,& constipation (stool softeners) |
What medication can you use for intercranial pressure | Corticosteroids may help decrease cerebral edema and I CP, mannitol is a diuretic that draws Edema fluid from the tissue spaces into the bloodstream, other diuretics such as furosemide may also be used to reduce Edema |
How do you care for a craniotomy | Monitor level of consciousness, vital signs, movement and strength, people‘s eyes and response to light, and speech |
Signs and symptoms of complications of a craniotomy | Headache, visual disturbances, vomiting, seizures, respiratory depression. |
. What position should you place the patient in after a craniotomy | Elevate the head of the bed 30° |
Nursing care for craniotomy | Frequent vitals, neurological checks hourly, maintain input and output records, inspect dressing for evidence of bleeding or cerebral spinal fluid drainage |