Complex Care of the Neuro Pt Flashcards
Blood Glucose
Sole energy source of the brain
Cerebral glucose less than 70 s/s
CONFUSION
Cerebral glucose less than 20 s/s
Damage
Increased MAP causes cerebral
consriction
Decrease MAP causes cerebral
Dilation
Elevated CO2 causes cerebral
vasodilation
Decrease 02 (hypoxia) causes cerebral
Vasodilation
Cerebral Perfusion Pressure
CPP= MAP - ICP
Normal CPP 60 - 100
Cerebral circulation
Cerebral veina - venous sinuses - internal jugular - superior VC
Co2 is a
VASODILATOR
Hypotension causes ? in cerebral circularion
Decrease cerebral Blood flow
Hypertension causes ? in cerebral circulation
ICP
Normal ICP
0 - 15 mmHg
Increased ICP
Greater than 20 mmHg for more than 5 minutes
ICP = MAP cerebral blood flow ceases. WHen does ICP = MAP
Hypotension, hypovolemia
Increased ICP Causes: Brain Volume
Cerebral Edema
Cytotoxic
Vasogenic
INcreased ICP Causes : Blood Volume
Loss of autoregulation
Decreased Oxygenation
Increased ICP Causes”: CSF
CSF is blocked
Increased ICP S/S
Decreased LOC (Glascow Coma Scale-GCS)
Unequal pupil size
Projectile vomiting
Headache
Altered breathing pattern
Cushing’s triad=bradycardia, hypertension (SBP), and bradypnea
Decreased brain stem reflexes
Cough/gag?
Papilledema
Decerebrate/Decorticate posturing
Decerebrate=arms/legs extended
Decorticate=arms flexed/legs extended
Meds for increased ICP
Osmotic Diuretics - mannitol, hypertonic saline
Loop diurerics
Fluid Adm - isotonic
CSF Drainage
Medical Management of ICP
BP - 70-90
avoid hypotension
avoid hypertension
temp control
seizure control
sedation
NM blockers
Nurse MAnagement ICP
Positioning: HOB elevated, neutral head position, turn side to side
Suctioning” only when necessary. Pre oxygenation, limit 10 seconds, 2 passes
Assessment - neuro exam , VS
