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2462 EXam
| Question | Answer |
|---|---|
| What are the key signs of increasing ICP? | Early: ↓ LOC, restlessness, confusion. Worsening: pupil changes, weakness/posturing. Late: Cushing triad. |
| Describe Cushing triad and what it means. | Bradycardia + widened pulse pressure + irregular respirations. Late sign of severe ↑ ICP/possible herniation. |
| How should a patient with ↑ ICP be positioned and why? | HOB ~30°, head/neck midline. Avoid neck/hip flexion. Promotes venous drainage and helps ↓ ICP. |
| What activities can increase ICP and should be minimized? | Coughing, suctioning, Valsalva, straining, agitation, pain, excessive stimulation and hip/neck flexion. |
| Explain MAP, ICP and CPP relationship. | CPP = MAP − ICP. As ICP ↑, CPP ↓. Low CPP → ↓ cerebral blood flow → ischemia. |
| What neurological changes suggest worsening ICP? | ↓ LOC, unequal/sluggish pupils, new weakness, abnormal posturing and decreased response to commands. |
| Compare decorticate and decerebrate posturing. | Decorticate = arms flexed, legs extended. Decerebrate = arms extended, legs extended; generally more severe. |
| How do oxygen and CO₂ affect ICP? | Hypoxia → cerebral vasodilation → ↑ ICP. Hypercapnia → cerebral vasodilation → ↑ cerebral blood volume/ICP. |
| What does mannitol do and what must the nurse monitor? | Pulls fluid from brain tissue. Monitor BP, urine output, renal function, electrolytes and serum osmolality. |
| What does hypertonic saline do in ↑ ICP? . | Pulls water from swollen brain tissue into circulation → ↓ cerebral edema and ICP |
| What nursing interventions help control ICP? | HOB 30°, head midline, maintain oxygenation, control fever/pain, prevent straining, limit stimulation and suction only PRN. |
| Why are serial neurological assessments important? | Trend LOC/GCS, pupils, strength, motor response and VS to detect deterioration early. |
| What is the Monro-Kellie doctrine? | Skull contains brain + blood + CSF. If one increases, another must decrease or ICP rises. |
| What findings suggest possible brain herniation? | Rapid ↓ LOC, fixed/dilated pupil, abnormal posturing, Cushing triad and respiratory changes. |
| What are the priorities if a neuro patient suddenly deteriorates? | ABCs → oxygenation → focused neuro/pupils → VS → recognize ↑ ICP/herniation → rapidly notify/escalate care. |
| Why are fever, seizures and agitation dangerous with | ↑ ICP? They increase cerebral metabolism/O₂ demand and may increase cerebral blood flow and ICP. |
| Calculate CPP: MAP 80, ICP 20. What does it mean? | CPP = 80 − 20 = 60 mmHg. CPP represents pressure available to perfuse the brain. |
| Calculate CPP: MAP 65, ICP 25. What is concerning? | CPP = 40 mmHg. Low cerebral perfusion increases risk for cerebral ischemia. |
| What should you remember about suctioning an ↑ ICP patient? | Suction only when necessary, keep it brief, maintain oxygenation and avoid repeated stimulation because suctioning can ↑ ICP. |
| What is the overall goal when caring for ↑ ICP? | Prevent secondary brain injury by maintaining oxygenation/perfusion, controlling ICP and recognizing deterioration early. |
Created by:
Anmag002
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