DONE: Disorders: Increased Intracranial Pressure (IICP) Flashcards
A Coma Score of 9 to 12 correlates with what level of brain injury?
Moderate brain injury
Headache. Pupillary changes. Changes in vital signs. Increased blood pressure. Decreased pulse rate. Changes in respiratory pattern. Projectile vomiting. These are the \_\_\_\_\_\_ Signs of IICP?
Late
In the late stages of Uncal IICP of the Temporal Lobe the nurse will see what signs and symptoms of Cushing’s Triad?
Cushing’s Triad includes:
- A change in respirations often becoming labored, irregular and deep such as Cheney-Stokes respirations.
- A widening pulse pressure which is the difference between the systolic and diastolic blood pressure.
- Bradycardia slow heart rate but the pulse is going to feel full and bounding.
Study Tip: During uncal herniation the innermost part of the Temporal lobe the Uncus can be squeezed so much that it moves towards the tentorium and puts pressure on the brainstem most importantly the midbrain.
Can drinking alcohol preserve cognitive function? What can this be combined with to make the patient smarter?
Studies show that social involvement and moderate alcohol consumption can help preserve cognitive function.
Exercise
Study Tip: This can be combined with exercise to make you smarter.
Why are anticonvulsants given to patients with increased intracranial pressure?
Anticonvulsants are given prophylactically to keep the patient from having a seizure when ICP increases.
Study Tip: The nurse would administer an anticonvulsant definitely for lobar which can lead to IICP. Anticonvulsants are used for seizure prophylaxis without suppression of cognitive abilities in patients with Intracerebral Hemorrhage.
What is the generic/trade name of the most common prescription barbiturate used to decrease IICP?
Phenobarbital/Nembutal
How do barbiturates treat intracranial pressure?
High-dose barbiturates have a hypotensive effect so they are used to control IICP. Barbiturates also decreased cerebral metabolism. This medication decreases cerebral blood volume and intracranial pressure, due to increase in cerebrovascular resistance, and due to vasoconstriction.
Study Tip: ICP is decreased due to decrease in Cerebral Blood Volume due to vasoconstriction caused by increase in cerebrovascular resistance.
Ex. During acute hypertension at pressures above the autoregulatory limit, the myogenic constriction of vascular smooth muscle is overcome by the excessive intravascular pressure and forced dilatation of cerebral vessels occurs. The loss of myogenic tone during forced dilatation decreases cerebrovascular resistance, a result that can produce a large increase in cerebral blood flow (300–400%), known as autoregulatory breakthrough In addition, decreased cerebrovascular resistance increases hydrostatic pressure on the cerebral endothelium, causing edema formation
What is the generic/trade name of a the most common prescription corticosteroid used to decrease IICP?
Dexamethasone/Decadron
What is the generic/trade name of a the most common prescription anticonvulsant used to treat IICP?
Phenytoin/Dilantin used as prophylaxis to prevent seizures.
A study done in 2011 states that staying involved and being social, getting out, and moving around can _____ cognitive function.
preserve
Intracranial pressure is a balancing act between the hard container which is the skull and the _________, _________, and _________.
Brain Tissue
Blood
Cerebral spinal fluid
__________ is measured in the CSF.
Hydrostatic force
Study Tip: Hydrostatic force is the pressure exerted by a fluid within a closed system.
This is a normal balance of Brain Tissue + Blood + CSF= __________
Intracranial Pressure
What 5 locations in the brain can ICP be measured using a Pressure Transducer?
Ventricles Subarachnoid space Subdural space Epidural space Brain tissue
What is the Normal range for ICP?
0-15 mm/Hg
The human body produces ______ of cerebral spinal fluid an hour; CSF is maintained by a delicate balance.
20-25mL
ICP is maintained at a relatively consistent pressure, and a relatively consistent volume of material inside the skull; if any of these 3 components increases: Brain Tissue + Blood + CSF, then intracranial pressure will _______.
Increase
Amount of cerebral blood flow in the brain in mL passing through 100 g of brain tissue in 1 minute is equal to ___ mL/min of brain tissue.
50 mL/min per 100 g of brain tissue
FYI: Cerebral Blood Flow
This is not something that we need to know right now, but if we hear it then we know what they are talking about.
_________ is a process where the brain can regulate its own blood flow in response to metabolic needs so even if there is wide fluctuations in systemic arterial pressure the brain can regulate that cerebral perfusion.
Autoregulation
FYI: Cerebral Blood Flow
This is not something that we need to know right now, but if we hear it then we know what they are talking about.
This disorder is caused by neurological changes which are developed after aspirin has been given to children with viral infections.
It is important to educate parents to be cautious when giving aspirin to children. What neurological disorder is this?
Reye’s Syndrome
Finish the Nursing Diagnoses related to IICP?
Ineffective tissue perfusion (cerebral) R/T
Reduction in arterial blood flow
or
Reduction in venous blood flow
Study Tip: anytime we use this type of diagnosis we NEED to be SPECIFIC about what tissue is going to lack perfusion.
What is the formula needed in order to calculate the cerebral perfusion pressure?
In order to calculate the CPP we take MAP (MEAN ARTERIAL PRESSURE) remember that a patient needs a MAP of 60 in order to survive and then subtract the ICP .
CPP = MAP-ICP
FYI: Cerebral Blood Flow
This is not something that we need to know right now, but if we hear it then we know what they are talking about.
Increased ICP is defined as a _______ above the upper limit of normal ICP and can be due to head trauma like a _______, hemorrhage, brain tumor, inflammation, ________, or brain tissue damage from other causes. This can be life threatening.
Sustained Pressure
Stroke
Hydrocephalus
Study Tip: Head trauma can cause edema in the brain.
What is a Vascular insult?
These are the physiological changes to a blood vessel that occurs after a CVA.