Increased Intracranial Pressure

Question 1

what is normal ICP?

Answer 1

normal ICP should be between 5-15 mm Hg, above 15 means there is a lot of pressure in the brain

Question 2

what is normal CPP?

Answer 2

cerebral perfusion pressure normals range from 70-95

Question 3

How can you can calculate CPP?

Answer 3

MAP-ICP = CCP

Question 4

what is the first sign of an increased ICP?

Answer 4

Decreased LOC is always the first sign

Question 5

what is the cushing’s triad and when does it occur?

Answer 5

cushing’s triad is very bad and is a late sign of IICP.

1. hypertension with widening pulse pressure
2. bradycardia
3. irregular respirations (cheyne-stokes)

Question 6

what are clinical manifestations of an increased ICP?

Answer 6

1. decreased LOC
2. severe headache
3. pupils will be uneven, sluggish and blurry
4. increased fever
5. decorticate or decerebrate posturing
6. cushing’s triad

Question 7

How should the nurse assess a patient’s ABGs if they have increased ICP?

Answer 7

keep CO2 at a low normal (35-45) because CO2 dilates cerebral vessels and increases cerebral blood flow so constriction is necessary

Question 8

how can the nurse help keep CO2 low in a patient experiencing IICP?

Answer 8

intubate and then increase respirations to decrease CO2

Question 9

what does the nurse want the PaO2 of a IICP patient to be?

Answer 9

keep PaO2 > 60

Question 10

what interventions can the nurse do to decrease ICP for a patient?

Answer 10

1. keep HOB at 30 degress but no higher
2. maintain body midline and c-spine until cleared
3. provide a calm environment

Question 11

what diagnostic test cannot be given for a patient with increased ICP?

Answer 11

lumbar puncture due to the risk of herniation

Question 12

what is a ventricuostsomy?

Answer 12

a sterile procedure that measures ICP and can also help treat increased ICP because it releases CSF through sterile drainage system and releases pressure

Question 13

where should the transducer be placed during a ventriculostomy procedure?

Answer 13

keep the transducer “0” at the level of tragus

Question 14

how frequently should neuro checks be done with a patient who has IICP?

Answer 14

neuro checks (GCS) should be done typically every 15 minutes for at least 24 hours

Question 15

what ranges should a patients blood glucose be at if they have an increased ICP?

Answer 15

keep blood glucose at 140-180 because these patients need alot of energy and if their glucose thanks (hypoglycemia), it can be DEADLY

Question 16

what medications help treat increased ICP?

Answer 16

1. mannitol
2. hypertonic solutions
3. corticosteroids
4. opioids

Question 17

what is the purpose of taking mannitol?

Answer 17

mannitol is an osmotic diuretic that expands plasma and pulls fluid from the brain to let kidneys pee it out

Question 18

what is the purpose of taking a hypertonic solution?

Answer 18

moves water out of edematous brain cells into blood vessels so that kidneys pee it out

Question 19

what patients do you avoid giving opioids to if they have increased ICP?

Answer 19

avoid in those who are not mechanically ventilated because this can cause inaccurate neuro assessment

Question 20

what actions should be avoided to prevent increased ICP?

Answer 20

1. HOB at > or < 30 degrees
2. increasing intraabdominal pressure by wearing restrictive clothing, coughing, or valsalva maneuvers
3. endotracheal or oral suctioning

Question 21

what type of precautions should increased ICP patients be on?

Answer 21

seizure precautions because increased ICP can cause seizures to occur