Quiz 4 Flashcards
Intracranial pressure
The amount of pressure within the skull
Normal 1-10
ICP >15-20 sustained is a problem
Cerebral perfusion
Pressure required to perfuse the brain
MAP-ICP
CPP must be at least 60
ICP priority assessments
Change in LOC Headache N and V Agitation Change in behavior
High ICP treatment
O2 elevate HOB Low stimulus( turn off lights) Brain the brain Intubated(pain and sedation)
Meds for increased ICP
Mannitol
Mannitol
Osmotic diuretic
Draws fluids out of brain cells
IV administration
Serum osmolality must be
How do we know mannitol is effective
Increased LOC
Decreased ICP
increased urine output
Sedation
Pain, low stim
Propofol
Pentobarbital
Analgesia
Fentanyl
Pain, decreased O2 demand
Antipyretic
Pain, fever, infection
Acetaminophen
Antihypertensive
CPP at optimal range
Vasoconstrictor
Prevent increase in ICP
Norepinephrine
Anticonvulsant
Prevent seizure
Phenytoin
Sympathetic storming
Release of fight or flight hormones by adrenal glands
Symptoms of sympathetic storming
GCS of 3-8 Agitation Posturing HTN Increased ICP Sweating Tachy
Interventions for sympathetic storming
Adsf
What happens if no interventions for storming
Asked
Brain herniation
ICP out of control leads to brain death
Swollen brain tissue is trapped
Finds opening in C1
SIADH
Hypervolemic(dilute)
Hyponatremic
Low urine output-highly concentrated
Treatment for SIADH
Fluid restriction 3% saline(drive up sodium) Diuretic Neuroassement Electrolytes
Diabetes insipid us
Deficient ADH
Large amounts of diluted urine
Hypernatremia
Treatment of diabetes insipidus
Fluid that comes out goes back in
ADH(short term)
Demopressin
I/O
Monro-kellie theory
3 components of brain must remain relatively constant
Increased ICP
Increased tissue, blood, CSF
Decreased CPP
Causes of increased ICP
Hematoma Contusion Tumor Edema Head injury
Symptoms on increased ICP
Change in LOC Change in vitals Dilation of pupil Decrease motor function Headache Vomitting
Complications of increased ICP
Herniation
Decreased perfusion
Cushings triad
Hypertension
Bradycardia
Irregular respirations
Medical emergency
Diagnosis of increased ICP
CT MRI EEG ICP measurement GCS
Ventriculostomy
Catheter inserted in brain ventricle hooked to a monitor
Must be level
Types of TBI that cause increased ICP
Concussion DAI Hematoma Subdural hematoma Any head injury
Craniotomy
Burr hole and saw
