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16 Cards in this Set
- Front
- Back
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What is the normal ICP range? |
5-15 mmHg |
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What are the common causes of ICP? |
Trauma, hemorrhage, edema, tumors |
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What do you assess? |
Level of consciousness (It decreases as ICP increases) |
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This is the earliest sign of ICP |
Decreased level of consciousness |
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The client will often appear? |
Restless, agitated, complaining of headaches |
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What will babies physically present with? |
Bulging fontanelles |
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Late signs of ICP are? |
Unilateral pupil dilation, hypotension, bradycardia |
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Client may complain of ? |
Projectile vomiting without nausea |
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How will the vital signs appear with ICP? |
BP (up), Temp (up), Resp (up then down), Heart rate (up) |
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What is widening pulse pressure and how it is related? |
When systolic BP goes up and diastolic continues to go down so that they become further apart (e.g. 135/40 is a bad sign!) |
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What is Cushing's Triad |
Three things: widening pulse pressure, Cheyne stokes respirations, bradycardia |
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What precaution you need to initiate? |
Seizure precaution |
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Why you need to elevate head of the bed? |
Elevate 10 to 30 degrees to promote jugular venous outflow |
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What medications will be prescribed? |
Anti-convulsants Blood pressure medications Corticosteroids Diuretics |
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Tell the client not to? |
Strain, cough, or sneeze |
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Nursing interventions would be to |
Decrease environmental stimuli Maintain body temperature Limit fluid intake Monitor intake and output |
