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ICP

Neuro Exam

QuestionAnswer
Cranial vault contains what? Brain tissue, blood, measured lateral ventricle
Normal amount of blood is ____mL. Normal amount of CSF is _____ mL 75 mL, 75 mL
Normal ICP is up to how much mmHg? What is the upper limit? Treat if > ? 10; 15; 20
What hypothesis states that an increase in any one of the components causes a change in the volume of others? Monroe-Kellie Hypothesis
According to Monroe-Kellie Hypothesis, compensation is accomplished by displacing or shifting _____; Increasing the absorption or diminishing production of ____; Decreasing cerebral blood volume CSF; CSF
Increased ICP may reduce CBF and result in _____ and cell ______ Ischemia; cell death
In early stages of cerebral ischemia, vasomotor centers are stimulated and systemic pressures rise to maintain CBF, accompanied by a ________, ______ pulse and RR ______. slow, bounding; irregularities
CO2 in blood also plays a role in regulation of CBF. Increase in PaCO2 causes _________. Decrease in PaCO2 causes _________. Vasodilation; Vasoconstriction
Body tries to compensate for ICP. Compensatory mechanisms include? Autoregulation; decreased production and flow of CSF
Term refers to the brain's ability to change the diameter of blood vessels to maintain a constant cerebral flow of blood during changes in systemic blood pressure Autoregulation
Autoregulation can be impaired in pts with sustained _____ ICP
Condition seen in pts with significantly decreased CBF. Cushing's response
What are the s/s of Cushing's Triad? Bradypnea, HTN, Bradycardia
Clinical manifestations of increased ICP depend on the rate of pressure increase and location in the brain. Changes in LOC indicates Cerebral hypoxia
An early sign (other than change in LOC) of ICP is changes in cranial nerve exam, especially slow-reacting ________ Pupils
First sign of ICP is Vomiting without nausea
Unrelieved ICP may result in pathologic ______ posturing
What are three complications of ICP? Brain stem herniation, SIADH, DI
Changes in VS with ICP can manifest as? HR brady to tachy; Increase systemic BP with widening pulse pressure; T may rise; RR pattern irregular (may have Cheyne-Stokes)
Medical management goal of ICP is the prevention of ______ _______ d/t _______ ______ and ____. 2nd injury; cerebral edema and ICP
Treatment of ICP may be medical or ________ Surgical
Procedure for ICP monitor: Catheter into the right lateral ventrical; facilitates intraventricular drug admin and facilitates removal and/or sampling of CSF Ventriculostomy
On ICP monitor A wave indicates cerebral ischemia
On ICP monitor B wave indicates incracranial HTN and variations in RR cycle
On ICP monitor C wave indicates variations in systemic arterial pressure and RR
What are three complications of ICP monitor device? Ventricular infection, meningitis, occlusion of cath with brain tissue or blood
What are three main interventions for decreasing cerebral edema? Osmotic diuretic (Mannitol), Fluid restrictions, Hypothermia
Osmotic diuretic (Mannitol) pulls fluids from brain tissue into _______ space vascular
Reduce CSF and intracranial blood volume by ______ CSF. PaCO2 should be brought to ____ to _____ Draining; 30-34
Maintain oxygenation and decrease metabolic demands by obtaining ABGs and pulse ox, sedation with ________ and paralyzing agent such as ______ Barbiturates, Propofol
Created by: mreedy