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NCM116 > ICP > Flashcards

ICP Flashcards

1
Q

ICP measurement

A

> 15 mmHg

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2
Q

ICP measurement acc. to Brunner

A

10-20 mmHg

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3
Q

Causes of ICP

A

Head injury
stroke
inflammatory lesions
brain tumor
Surgical complications

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4
Q

Components of cranium (brain substance)

A

CSF and blood/blood vessels

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5
Q

An increase in any of the components causes a change in the volume of the other

A

MONRO-KELLIE hypothesis

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6
Q

Any alteration of brain substances or structure will cause

A

increase ICP

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7
Q

Compensatory mechanisms

A

Increased CSF absorption
Blood shunting
Decreased CSF production

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8
Q

Decompensatory mechanisms

A

Decreased cerebral perfusion
Decreased PO2 = brain hypoxia
Cerebral Edema
Brain herniation

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9
Q

Vasomotor reflexes are stimulated (Decreased cerebral bld flow)

A

slow bounding pulses

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10
Q

Increased concentration of CO2 (Decreased cerebral bld flow)

A

Vasodilation—Increased flow—Increased ICP

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11
Q

Abn accumulation of fluid in intracellular space, extracellular space or both

A

Cerebral edema

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12
Q

Results from an excessive increase in ICP when the pressure builds up and the brain tissue presses down the brain stem

A

Herniation

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13
Q

Cerebral response to Increase ICP

A

Cushing’s response
Altered LOC
Headache/Migraine

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14
Q

Cushing’s response

A
  1. Vasomotor center triggers rise in BP to increase ICP
  2. Sympathetic response is increased BP but the heart rate is SLOW
  3. Slow Respiration
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15
Q

Early Manifestation

A

*Changes in LOC (earliest)
*Pupillary changes - fixed, slowed response
*Headache
*Vomiting

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16
Q

Later manifestation

A
  1. cushing reflex (systolic hypertension, bradycardia, wide pulse pressure)
  2. Bradypnea
  3. Hyperthermia
  4. Abn posturing
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17
Q

Nursing intervention to Increased ICP

A
  1. Elevate head of bed 15-30 deg
  2. assist in adm 100% O2 or controlled hypervent
  3. Adm prescribed meds
  4. reduce environmental stimuli
  5. Avoid act. that increase ICP
  6. Keep head in neutral position
  7. Monitor for secondary complications
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18
Q

Elevate the head of the bed 15-30 degrees-

A

to promote venous drainage

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19
Q

assists in administering 100% oxygen or controlled hyperventilation-

A

to reduce the CO2 blood levels—constricts blood vessels—-reduces edema

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20
Q

Prescribed meds for ICP

A

Mannitol
Corticosteroid
Anticonvulsant

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21
Q

med to produce negative fluid balance

22
Q

med to reduce edema

A

corticosteroid

23
Q

med to prevent seizures

A

Anticonvulsants

24
Q

activities that can increase ICP

A

valsalva, coughing, shivering, and vigorous suctioning

25
Q

what position to avoid

A

Extreme flexion
Valsalva

26
Q

Secondary complications

A

*DI - output of >200 ml/hr
*SIADH

27
Q

It is a function and symptom of multiple
pathophysiologic phenomena

A

Altered LOC

28
Q

Disruption in the neuronal transmission
results to improper function

A

Altered LOC

29
Q

Causes of Altered LOC

A

Head injury, toxicity, and metabolic derangement

30
Q

Assessment for Altered LOC

A

*Orientation of time, place and person
*Motor function
*Decerebrate (extensor)
*Decorticate (flexor)
*Sensory function

31
Q

Decorticate causes

A

Problems with cervical spinal tract or cerebral hemisphere (C’s)

32
Q

Decerebrate causes

A

Problems with midbrain or Pons (E’s)

33
Q

Altered LOC pt

A

*Not oriented
*Does not follow command
*Needs persistent stimuli to be awake
*COMA

34
Q

clinical state of unconsciousness where patient is NOT aware of self and environment

35
Q

Etiologic factors of altered LOC

A
  1. Head injury
  2. Stroke
  3. Drug overdose
  4. Acl intoxication
  5. Diabetic Ketoacidosis
  6. Hepatic failure
36
Q

Assessment for Altered LOC

A

1.Behavioral changes initially
2.Pupils are slowly reactive
3.Then , patient becomes unresponsive
and pupils become fixed dilated
*Glasgow Coma Scale is utilized

37
Q

Nursing intervention for altered LOC

A
  1. Maintain patent airway
  2. Protect pt
  3. Maintain fld and nutritional balance
  4. Provide mouth care
  5. 5.Maintain skin integrity
  6. preserve corneal integrity
  7. Achieve thermoregulation
    8.Prevent urinary retention
  8. promote bowel function
  9. provide sensory stimulation
38
Q

Other term for headache

39
Q

no organic cause

A

primary headache

40
Q

with organic cause

A

secondary headache

41
Q

periodic attacks
of headache due to vascular disturbance

A

Migraine headache

42
Q

3 Phases of migraine

A
  1. Aura phase
  2. Headache
  3. Recovery phase
43
Q

Bright spots or flashing light

A

Aura phase

44
Q

Lasts from 5-60 minutes

A

Aura phase

45
Q

Initial stage of vasoconstriction

A

Aura phase

46
Q

Cerebral vasodilation

47
Q

Decrease serotonin levels

48
Q

Both sides, NV

49
Q

HA area is sensitive to touch

A

Recovery phase

50
Q

Feeling of exhaustion

A

Recovery phase

51
Q

Nursing Interventions for Headache

A

*Avoid precipitating factors
*Modify lifestyle
*Relieve pain by pharmacologic measures

52
Q

Analgesics for headache

A

Beta-blockers
Serotonin antagonists (triptan)

NCM116 (4 decks)

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