GF3: Neuro ICP Flashcards
What are some s/s of increased ICP?
- HA
- Decreased LOC
- Projectile vomiting
- Cushings triad
- bradycardia
- irregular respirations
- widened pulse pressure.
What are the factors that influence ICP?
- Arterial pressure
- Venous pressure
- Intrabdominal pressure
- Posture
- Temperature
- Blood gases (especially CO2 levels)
What is CPP?
- Cerebral perfusion pressure
- Pressure needed to ensure blood flow to the brain
What is the formula for MAP?
MAP = (SBP – DBP)/3+DBP
What is the formula for CPP?
CPP = MAP – ICP
What is MAP?
- Mean Arterial Pressure
- The average arterial pressure throughout one cardiac cycle, systole, and diastole.
- MAP is influenced by cardiac output and systemic vascular resistance
What is the desired MAP range?
70-105 mmHg
What is considered normal ICP?
5-15 mmHg
What is the desired CPP range?
60-100
CPP <50 or >150 are associated with…
Ischemia and neuronal death
High ICP means _____ CPP
Decreased
How does a loss of cerebral autoregulation that results in high BP cause increased ICP?
- High BP leads to increased cerebral blood volume
- Increased cerebral blood volume leads to extravasation and edema
- Extravasation increases ICP
How does a loss of cerebral autoregulation that results in low BP cause increased ICP?
- Low BP leads to decreased cerebral blood volume
- Decreased cerebral blood volume leads to hypoxia, hypercapnia and acidosis which lead to increased ICP
How does increased ICP manifest in the eyes?
- Papilledema
- Pupillary changes
- Impaired eye movement
Headache and seizures are a risk w/ increased ICP due to…
Lack of oxygen to brain tissues
How does increased ICP affect VS?
- Systolic BP rises due to resistance of increased ICP
- This causes the HR to slow down to lower BP
- Lower HR = lower diastolic pressure which widens pulse pressure
What is pulse pressure?
The difference between systolic and diastolic pressures
True or False
ICP will not change speech function or comprehension.
False, it can
What are some causes of increased ICP?
- Increased blood volume
- Increased CSF
- Brain tissue edema
- Dilated cerebral arteries
What are the risk factors for increased ICP?
- Brain tumor
- Closed head injury
- Ruptured blood vessels
- Embolism
- Thrombosis and ischemia
- Hydrocephalus
Dx tests for ICP?
- CAT scan (first)
- MRI
- PET (monitor glucose levels)
- ICP monitoring
- EEG
What are some complications that occur due to increased ICP?
- Herniation
- SIADH
- Diabetes insipidus
What are the nursing interventions to ID and decreased ICP?
- Neuro checks hourly
- Elevated HOB
- Change position slowly
- Maintain hydration (w/ NS, NOT DM5)
- Monitor I/O
- No sedatives, narcotics or coughing
- Hypothermia
What are the nursing interventions regarding respiratory function with increased ICP?
- Immobility
- Maintain patent airway
- Monitor PCO2 for acidosis
- Suction GENTLY
- Monitor ventilator if employed
