ch 56 intracranial pressure

Question 1

what is considered increased intracranial pressure (IICP)

Answer 1

> 20 mmHg (normal = 10-15)

Question 2

what is normal cerebral perfusion pressure

Answer 2

70-100 mmHg

Question 3

factors that can increase intracranial pressure (5)

Answer 3

• increased arterial pressure
• increased venous pressure
• posture (lying flat)
• increased temp
• increased CO2

Question 4

late S+S IICP (5)

Answer 4

• hypertension (increased Sbp)
• bracycardia
• decreased respirations
• abnormal response to pain
• abnormal motor function (impaired flexion + extension)

Question 5

S+S shock (3)

Answer 5

• hypotension
• tachycardia
• increased respirations

Question 6

complication of IICP

Answer 6

tentorial herniation (brain herniates onto spinal cord) and leads to death

Question 7

early S+S IICP (3)

Answer 7

1) change LOC
2) changes in pupils and size (pupils sluggish then fixed)
3) irregular respirations
- headache
- vomiting (projectile) not preceded by nausea

Question 8

abnormal flexion with IICP

Answer 8

decorticate

Question 9

abnormal extension with IICP

Answer 9

decerebrate

Question 10

what are pts with IICP at high risk for

Answer 10

infection

Question 11

treatment IICP (5)

Answer 11

• adequate O2
• meds (especially mannitol and pentobarbital)
• hyperventilation therapy (with ventilator pt)
• nutrition: increase calories and increase glucose
• positioning: hob 30-45

Question 12

meds for reducing IICP (7)

Answer 12

• mannitol
• pentobarbital (for medically-induced coma)
• corticosteroids (dexamethasone)
• antiseizure drugs
• H2 blockers/PPIs (prevent stress ulcers)
• acetaminophen (reduce fever)
• morphine (pain)