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Intracranial pressur

What is normal intra-cranial pressure? 5-15 mmHg
What is the main reason fro low cranial pressure? dehydration
What causes higher cranial pressures? Val Salva, Tumor, Hydrocephalus, Head injury, inflammation, metabolic insults
What are the compensatory mechanisms for cranial pressure fluctuations? alteration of CFS absorption and production, displacement of CFS into spinal subarachnoid space, and dispensibility of dura
How is CBF maintained? Through autoregulation: automatic alteration in diameter of vessels
What should the MAP of cerebral perfusion pressure? 50-150 mm Hg
How is cranial pressure regulated via BP? When BP is high, cerebral arteriols constrict, when BP is low, cerebral arteriols dilate to increase CBF
How is cranial pressure maintained through metabolic regulation? Low O2 and high CO2 causes vasodilation and also causes CSF reabsorption and and decreased production
What is compliance in the brain? expandibility of the brain
What are the late compensatory stages? Loss of autoregulation, signs of IICP
If IICP continues, what chain of events are likely to happen? lethal level of ICP, displacement of brain tissue, herniation and death
What are the S/S of herniation? decreased LOC, pupil abnormalities, motor dysfunction- hemiplegia, decerebate (extensor) and decorticate (flexor), impaired brain reflexes- gag, corneal, swallowing, and Cushing's Triad- increased SBP and pulse pressure, bradycardia and RR irregularities
What are the clinical manifestations of IICP? decreased LOC, restlessness, irritability, HA, confusion, decreased Glascow coma scale, changes in speech, sluggish pupil response, bradycardia, V (not preceded by N), double vision, pitosis, inability to move eye upward, increased SBP, seizures
What is the Cushing's Triad? SBP increase=widened pulse pressure, decreased HR, decreased RR
What complications result from IICP? inadequate cerbral perfusion, hernation
What types of medical management is used? ICP monitoring, meds, hyperventilation (mild) and nurtition
What is the most common used osmotic diuretic? mannitol
What type of loop diuretics are used? lasix
Which cortecoid steriod is most commonly used? decadron
What antacids are used? Tagamet
What is the gold standard for measuring ICP? ventriculostomy
When is ICP measured? At the end of expiration
What should be considered with ICP monitoring? infection, bubbles, kinks, dislocation, waveform, amount of drainage
What are complications of ICP monitoring? infection, respiratory distress, hydrocephalus, meningitis, hematoma
What level should the bed be at? HOB 30 degrees
What should be reported to MD? high levels of UO
What special consideration should be taking when suctioning? Less than 10 seconds
Created by: brebre273