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Level 3 > Complex Exam 3 - intracranial regulation > Flashcards

Complex Exam 3 - intracranial regulation Flashcards

1
Q

What is a normal ICP?

A

5/10-15 mmHg

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2
Q

What is a normal CPP?

A

60/70-95/100

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3
Q

How is CPP calculated?

A

MAP-ICP

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4
Q

What is a normal MAP?

A

70-100

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5
Q

How is MAP calculated?

A

3

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6
Q

How should the HOB be to decrease ICP?

A

at least 30

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7
Q

What can increase ICP?

A
  • hypercarbia
  • suctioning
  • coughing, vomiting
  • neck or hip flexion/extension
  • increased abdominal pressure
  • hyperthermia
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8
Q

How can ICP be decreased?

A
  • keeping the body midline
  • maintaining a patent airway and c-spine
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9
Q

What are the earliest signs of increased ICP?

A
  • altered LOC: confusion
  • altered respirations: cheyne-stokes
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10
Q

What are the characteristics of the eyes with increased ICP?

A
  • uneven pupils (larger on the side of injury)
  • double or blurred vision
  • sluggish progressing to fixed
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11
Q

Where does weakness or paralysis occur with increased ICP?

A

on the opposite side of the injury

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12
Q

What posturing is a late sign of increased ICP?

A

decorticate or decerebrate

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13
Q

What does Cushing’s triad consist of?

A
  • severe HTN with widening pulse pressure
  • decreased HR and RR
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14
Q

What can be done to monitor ICP?

A
  • bolts
  • ventriculostomy
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15
Q

What is the ideal blood pressure of someone with increased ICP?

A

slight HTN

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16
Q

What does a ventriculostomy do?

A
  • monitor ICP
  • drain CSF
17
Q

What surgical procedure can be done for increased ICP?

A

craniotomy

18
Q

What PaO2 level should be maintained?

19
Q

What PaCO2 level should be maintained?

20
Q

How can CO2 be blown off in an intubated patient?

A

hyperventilate, speed up RR

21
Q

What does mannitol do?

A

pulls fluid off the brain

22
Q

Can mannitol be given to patients with renal disease, anuria, or cerebral hemorrhage?

23
Q

How long does mannitol take to go into effect?

A

15-30 mins

24
Q

What does hypertonic saline do?

A

moves water out of edematous brain cells

25
Q

What is phenobarbital used for?

A

decreased ICP and edema

26
Q

What are corticosteroids used for?

A

to decrease inflammation and edema

27
Q

What anti-seizure medications can be given?

A

phenytoin and lorazepam

28
Q

Why might opioids or sedative meds be ruled out for neuro patients?

A
  • respiratory depression
  • decreased level of consciousness
  • pupillary changes
29
Q

Can you drain a lot of CSF from a ventriculostomy at once?

Level 3 (29 decks)

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