Neuro 10 Q Flashcards
Normal ICP; greater than _ TREAT!!
5-15; >20 treat!
What is the earliest indicator of increased ICP?
Change in LOC
Cushings triad is an emergency that indicates the brain is no longer compensating for increased ICP. What does this consist of?
increasing SBP, bradycardia with bounding pulse, and altered respirations
Gold standard for ICP monitoring is the ventriculostomy. The transducer will need to be leveled with the _. Make sure it is level every time you move the patient
Foramen of Monroe (Tragus of the Ear)
A normal ICP waveform resembles a
Staircase
Normal CPP
60-100; CPP=MAP-ICP
CPP Less than 50 is bad, but CPP less than 30 is death
Any patient who becomes acutely unconscious should be suspected of
increased ICP
Primary cause of increased ICP
Cerebral edema
2 major complications of increased ICP
inadequate CPP and cerebral herniation
2 treatments used for increased ICP
mannitol, hypertonic saline
When giving Mannitol, what is super important for the nurse to remember?
NEVER give it fast
Fixed, dilated pupils are an _ sign
Ominous
What volume status should be maintained for increased ICP?
Euvolemia
Suctioning increases ICP, keep each pass < _ seconds
10
Emergency with bleeding between the dura and the inner surface of the skull. It can be venous or arterial. Arterial develops more rapidly.
Epidural hematoma
Acronym FAST describes symptoms of a CVA. What are these?
Facial drooping, arm weakness, speech difficulties, time (its critical)
When a patient presents with a stroke, CT should be done within _ minutes and read within _ minutes
25 minutes, 45 minutes
A major nursing goal for a stroke patient is to reduce secondary injury r/t
increased ICP
What is the biggest risk factor for CVA?
Uncontrolled/undiagnosed HTN
See back of card for emergency stroke management
Ensure airway, call code/stroke team, remove dentures, pulse ox, maintain O2, IV access w/ NS, maintain BP, immediate CT, baseline labs, tx hypoglycemia, position head midline with HOB 30, seizure precautions, anticipate thrombolytics for ischemic
Cell death occurs in _ minutes without blood flow to the brain
5 minutes
The patient with an ischemic stroke usually remains
conscious but has a headache
Most important part of history in an ischemic stroke
Time of symptom onset
For fibrinolytic therapy, you must maintain the BP less than
185/110 and for 24 hours after therapy
In an ischemic stroke, avoid IV solutions that contain _ because they are hypotonic and further increase ICP
Glucose
TPA must be given within _ to _ hours after ischemic stroke symptoms begin
3-4.5 hours
Ischemic stroke can be _ or _
Thrombotic or embolic
Thrombotic is most common
Hemorrhagic stroke often has a _ onset with progression over minutes to hours
rapid
Manage _ in an hemorrhagic stroke
Hypertension
3 tests for brain death
Oculocephalic (dolls eye), oculovestibular, apnea test
Call KODA if a patient is < or equal to _ on the GCS scale
8
Best GCS
15
GCS less than _ is coma
8
GCS less than _ is deep coma
3
