Increased Intracranial Pressure Flashcards

1
Q

what is normal ICP?

A

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

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2
Q

what is normal CPP?

A

cerebral perfusion pressure normals range from 70-95

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3
Q

How can you can calculate CPP?

A

MAP-ICP = CCP

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4
Q

what is the first sign of an increased ICP?

A

Decreased LOC is always the first sign

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5
Q

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

A

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)
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6
Q

what are clinical manifestations of an increased ICP?

A
  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
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7
Q

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

A

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

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8
Q

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

A

intubate and then increase respirations to decrease CO2

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9
Q

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

A

keep PaO2 > 60

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10
Q

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

A
  1. keep HOB at 30 degress but no higher
  2. maintain body midline and c-spine until cleared
  3. provide a calm environment
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11
Q

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

A

lumbar puncture due to the risk of herniation

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12
Q

what is a ventricuostsomy?

A

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

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13
Q

where should the transducer be placed during a ventriculostomy procedure?

A

keep the transducer “0” at the level of tragus

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14
Q

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

A

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

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15
Q

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

A

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

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16
Q

what medications help treat increased ICP?

A
  1. mannitol
  2. hypertonic solutions
  3. corticosteroids
  4. opioids
17
Q

what is the purpose of taking mannitol?

A

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

18
Q

what is the purpose of taking a hypertonic solution?

A

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

19
Q

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

A

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

20
Q

what actions should be avoided to prevent increased ICP?

A
  1. HOB at > or < 30 degrees
  2. increasing intraabdominal pressure by wearing restrictive clothing, coughing, or valsalva maneuvers
  3. endotracheal or oral suctioning
21
Q

what type of precautions should increased ICP patients be on?

A

seizure precautions because increased ICP can cause seizures to occur