Head injuries

Question 1

How elevated should the head be with increased ICP

Answer 1

15-20 degrees

Question 2

MAP formula

Answer 2

SBP + (2) DBP / 3

Question 3

CPP formula

Answer 3

MAP - ICP

Question 4

What score on the Glasgow Coma Scale is indicative of a coma?

Answer 4

7 or less

Question 5

the priority nursing assessment for the client at risk for increased ICP

Answer 5

Unequal pupil size

Question 6

The first thing a nurse should do if a client has clear drainage from the nose

Answer 6

collect and analyze clear drainage

Question 7

What do respirations look like when increased ICP is occurring

Answer 7

Rapid and irregular

Question 8

If ICP starts to elevate, what is a nursing intervention that the nurse can ask of the patient to decrease it:

Answer 8

hyperventilate

Question 9

An early indicator of a patient decrease in neurological function

Answer 9

Change in LOC

Question 10

3 changes that indicate an increase in ICP

Answer 10

Bradycardia

Increase Systolic BP

Widen Pulse pressure