Increased Intercranial Pressure Flashcards
How to manage/NI
–
Notify Physician S/S / consult Neurology
obtain orders / interd approach
Maintain a patent airway
Decreasing LOC puts patient at risk for obstructed airway from tongue dropping back occluding airway or accumulation of secretions
02
aid in tissue oxygentation needs/ to support brain function
raise hob
Raising head of bed to 30 degrees aids in decreasing ICP by venous drainage / increases respiratory exchange
obtain Iv access
to adminster meds
mannitol
corticosteroids
Frequent Neurochecks / vs : BP, Temp, RR, Pulse
Assess possible deterioration of status. Q15min for first hour
Q30Hr next 2 hrs
Avoid positions/activities that increase ICP
Avoid Neck flexion: causes venous obstruction
Avoid Straining : may stimulation vagal response , increases ICP ,
Cluster nursing interventions
Decrease environmental stimuli
aids in preventing increased ICP -Cluster nursing interventions
Monitor I/O
To assess for complications such as Diabetes insipidous / SIADH
Assess for changes in VS
To determine Cushing’s Triad indication severely increased ICP: Emergency
Control Fever
Induce Hypothermia=cool blankets , cool bath
Avoid Shivering , shaking (96.8-98.6)
induce hyperventilation = constricts blood vessel decreasing ICP
Seizure precautions
may increase ICP ; Prophylactic antiseizure meds anticipated
WHAT DATA TO REPORT TO PHYSICIAN?
LOC
2 report
BP/Pulse / RR/ Temp
