neuro pt. 3

Question 1

physical symptoms of inc. ICP

Answer 1

dec. LOC
pupils dialte
dec acuity of vision
blurred vison
diplopia
alterations in sensory and motor function

Question 2

treatment goals of inc. ICP

Answer 2

reduce icp
optimize cpp (cerebral perfusion pressure)
maintain adequate tissue oxygenation
avoid brain herneation

Question 3

what are the 3 treatments for inc. icp

Answer 3

osmotic diuretics (mannitol)
hypertonic IVF (if cerebral edema / low sodium)
surgery

Question 4

what osmotic diuretic is used to help treat inc. ICP

Answer 4

mannitol

Question 5

what is important to monitor for while using mannitol to lower icp

Answer 5

hypovolemia from diuresis

Question 6

what fluid must never be given with inc. ICP

Answer 6

hypotonic fluids (increases cerebral edema)

Question 7

what surgeries help to treat increased ICP

Answer 7

decompressive craniotomy (opens dura for more room)
hematoma evacuation
remove tumor

Question 8

what interventions help treat inc. icp

Answer 8

hyperventilation!! (vasodilation)
minimize stimulation
prevent valsalva
no trendelenberg
patent airway

Question 9

which diuretics help decrease cerebrospinal fluid (CSF) to decrease icp

Answer 9

loop diuretics (furosemide)

Question 10

what CSF draiange system is used to help dec. ICP

Answer 10

ventriculostomy!

Question 11

what is the most sensitive indicator if inc. ICP

Answer 11

dec. LOC

Question 12

what does posturing indicate

Answer 12

some brain function, not braindead

Question 13

is posturing bad?

Answer 13

yes

Question 14

which posturing is where arms/wrists/figners are flexed, pulled in to the body, arms are at the core of the body

Answer 14

decorticate

Question 15

which posturing is where arms are to the side, has extension and abdustion, hyperpronation of upper extremities

Answer 15

decerebrate

Question 16

which posturing is worse

Answer 16

decerebrate

Question 17

describe doll’s eye test

Answer 17

head turned to the side, eyes should follow
checks for braindeath

Question 18

describe cold calorics test

Answer 18

cold water inserted into ear, eyes should turn to the side the cold is inserted

Question 19

describe clinical determination of brain death

Answer 19

-imaging or clinical evidence consistent with brain death
-r/o conditions such as metabolic or endocrine imbalance
-r/o drug intoxication or poisoning
-body temp >32 C or 90F or >36C for apnea test
-no motor response
-no brainstem reflexes
-loss of centrally controlled breathing
-EEG assessment

Question 20

cranial nerve III

Answer 20

corneal reflex

Question 21

cranial nerve IX and X

Answer 21

cough/gag reflexes

Question 22

which brainstem reflexes must be absent to classify braindeath

Answer 22

pupillary light reflex
corneal reflex (III)
cough/gag reflex (IX & X)
dolls eye / cold calorics

Question 23

which reduces brain volume
1) quiet environment
2) neck neutral position
3) ventriculostomy
4) mannitol

Answer 23

d) mannitol