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Intracranial pressur
| Question | Answer |
|---|---|
| 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
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