neuro pt. 3 Flashcards
physical symptoms of inc. ICP
dec. LOC
pupils dialte
dec acuity of vision
blurred vison
diplopia
alterations in sensory and motor function
treatment goals of inc. ICP
reduce icp
optimize cpp (cerebral perfusion pressure)
maintain adequate tissue oxygenation
avoid brain herneation
what are the 3 treatments for inc. icp
osmotic diuretics (mannitol)
hypertonic IVF (if cerebral edema / low sodium)
surgery
what osmotic diuretic is used to help treat inc. ICP
mannitol
what is important to monitor for while using mannitol to lower icp
hypovolemia from diuresis
what fluid must never be given with inc. ICP
hypotonic fluids (increases cerebral edema)
what surgeries help to treat increased ICP
decompressive craniotomy (opens dura for more room)
hematoma evacuation
remove tumor
what interventions help treat inc. icp
hyperventilation!! (vasodilation)
minimize stimulation
prevent valsalva
no trendelenberg
patent airway
which diuretics help decrease cerebrospinal fluid (CSF) to decrease icp
loop diuretics (furosemide)
what CSF draiange system is used to help dec. ICP
ventriculostomy!
what is the most sensitive indicator if inc. ICP
dec. LOC
what does posturing indicate
some brain function, not braindead
is posturing bad?
yes
which posturing is where arms/wrists/figners are flexed, pulled in to the body, arms are at the core of the body
decorticate
which posturing is where arms are to the side, has extension and abdustion, hyperpronation of upper extremities
decerebrate
which posturing is worse
decerebrate
describe doll’s eye test
head turned to the side, eyes should follow
checks for braindeath
describe cold calorics test
cold water inserted into ear, eyes should turn to the side the cold is inserted
describe clinical determination of brain death
-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
cranial nerve III
corneal reflex
cranial nerve IX and X
cough/gag reflexes
which brainstem reflexes must be absent to classify braindeath
pupillary light reflex
corneal reflex (III)
cough/gag reflex (IX & X)
dolls eye / cold calorics
which reduces brain volume
1) quiet environment
2) neck neutral position
3) ventriculostomy
4) mannitol
d) mannitol