Intracranial pressur
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| What is normal intra-cranial pressure? | 5-15 mmHg
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| What is the main reason fro low cranial pressure? | dehydration
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| What causes higher cranial pressures? | Val Salva, Tumor, Hydrocephalus, Head injury, inflammation, metabolic insults
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| 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
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| How is CBF maintained? | Through autoregulation: automatic alteration in diameter of vessels
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| What should the MAP of cerebral perfusion pressure? | 50-150 mm Hg
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| How is cranial pressure regulated via BP? | When BP is high, cerebral arteriols constrict, when BP is low, cerebral arteriols dilate to increase CBF
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| How is cranial pressure maintained through metabolic regulation? | Low O2 and high CO2 causes vasodilation and also causes CSF reabsorption and and decreased production
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| What is compliance in the brain? | expandibility of the brain
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| What are the late compensatory stages? | Loss of autoregulation, signs of IICP
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| If IICP continues, what chain of events are likely to happen? | lethal level of ICP, displacement of brain tissue, herniation and death
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| 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
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| 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
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| What is the Cushing's Triad? | SBP increase=widened pulse pressure, decreased HR, decreased RR
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| What complications result from IICP? | inadequate cerbral perfusion, hernation
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| What types of medical management is used? | ICP monitoring, meds, hyperventilation (mild) and nurtition
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| What is the most common used osmotic diuretic? | mannitol
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| What type of loop diuretics are used? | lasix
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| Which cortecoid steriod is most commonly used? | decadron
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| What antacids are used? | Tagamet
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| What is the gold standard for measuring ICP? | ventriculostomy
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| When is ICP measured? | At the end of expiration
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| What should be considered with ICP monitoring? | infection, bubbles, kinks, dislocation, waveform, amount of drainage
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| What are complications of ICP monitoring? | infection, respiratory distress, hydrocephalus, meningitis, hematoma
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| What level should the bed be at? | HOB 30 degrees
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| What should be reported to MD? | high levels of UO
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| What special consideration should be taking when suctioning? | Less than 10 seconds
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