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Intacranial Pressure

Intracranial Pressure

Name five causes of increased ICP traumatic brain injuries, brain tumors, meningitis, encephalitis, brain abscesses, hydrocephalus, infection, birth trauma
Name 8 signs of increasing ICP severe headache, deteriorating level of consciousness, restlessness, irritability dilated or pinpoint pupils slow to react/nonreactive, alteration in breathing pattern (cheyne stokes, hyperentilation, apnea) Deterioration in motor function, abnormal apnea
What are the characteristics of Cushing Reflex? Severe HTN, Bradycardia, Widening Pulse Pressure (between systolic and ditolic)
Name two medications usef for the medical management of ICP Mannitol - Osmotic Diuretic reduces edema through diuresis; Monitor urinary output Decadron - Corticosteroid reduces inflammation; Monitor blood glucose levels; Often accompanied by a proton-pump inhibotor or H2 Blocker Sedatives:Benzodiazepines
Name 6 common everyday activiteis that could increase ICP Coughing, suctioning, blowing nose forcefully, extreme neck of hip flexion, head of the be less than 30 degrees, increased intra abdominal pressure
Name 2 things you can do when suctioning to maintain airway patency When suctioning hyper oxygenate with 100% oxygen Limit thenumber of passes and <10 sconds each pass
What can the nurse do to decrease the chances of infection post craniotomy for ICP line pacement aseptic technique, sterile dressing changes per facility protocol, keep draininage system closed; irrigate only as needed to main patency, limit monitoring for 3-5 days
What is the Glasgow score for patient -eye opening to pain -Incomprehensible sounds -Withdrawal from Pain Eye opening to pain = 2 incomprehensible sounds = 2 withdrawal from pain = 4
Brain tissue weighs? 1400 g or 3 pounds
cerebrospinal fluid weighs 75 cc or 2.5 oz
what is normal intracranial pressure 10-15 mm hg
What pressure requires immediate medical intervention? pressures > 20 mm
What are some Increased Intracranial Pressure Clinical Manifestions Severe Headache Deteriorating Level Of Consciousness Restlessness Irriability Dilated or pinpoint pupils slow to react/nonreactive Altered Breathing Pattern Cushing Reflex
Cushing Reflex is a Late sign of ICP
What are signs of Cushing Reflex which is a late sign of ICP? Severe HTN Bradycardia Widening Pulse Prssure
Decerbrate indicates what? Upper Brain Stem Damage
Decorticate Damage to the Corticospinal tract, the pathway between the brain and the spinal cord
What are four methods of ICP monitoring? Intraventricular Subarachnoid Epidural or Subdural sensor Intraparencymal
What are some complications of Craniotomy/Placement of ICP Line? Infection, hemorrhage, fluid and electrolyte imbalance, CSF leak, DVT, Gastric Ulcers, pneumonia, diabetes insipidus, SIADH ( Syndrome of inappropriate Antidiuretic Hormone)
What is a criteria for ICP Monitoring? Clinets who are comatose and or have glasgow Coma score (GCS) of 8 or less
Mannitol For ICP Osmotic diuretic reduces edema through diuresis - Mx Urinary output
Decadron for ICP Corticoseroid reduces inflammation, monitor blood glucose levels. Often accompanied by a proton pump inhibitor or H2 blocker
Hypertonic Saline for ICP Reduce edema by rapid movement of water out of ventricles into blood stream
ICP increases with ? Coughing, suctioning, blowing nose forcefully, extreme neck of hip flexion, head of bed less than 30 degrees
In the glasgow Coma scale which is not true? 1. It is always has 15 ponts 2. It measures LOC 3. It is less vali when used by inexperienced users. 4. It is the only scale int he world where you can be dead and still score 3. 3. It is less valid when used by inexperienced users.
A pt is taken 2 surgery 4 placement of an ICP line. His wife is afraid and asks the nurse what is going to happen in surgery. What should the nurse say? The small area of the scalp will be shaved and then numbed
Which nursing diagnosis does this client have upon return from surgery for placement of ICP line? Risk for infection
What nursing interventions should be included in this ct's plan of care to decrease chances of infection post ICP line placement. perform sterile drsg change keep drainage system closed limit monitoring to 3-5 days irrigate system only as needed to maintain patency
A nurse is preparing to vie the patient post craniotomy for ICP line placement, a medication for incisional pain. The family asks why the pt is getting codeine and not something stronger? Codeine does not alter respiration or mask neurological signs
The nurse is positioning the patient with increased ICP? Which position would the nurse avoid? Head turned to side
A nurse determines that the patient understands measures to prevent elevation of ICP if the nurse observes the patient doing the following? Exhaling during repositioning.
Created by: starr8904