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34 Cards in this Set
- Front
- Back
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Symptoms of IICP are ________of Shock
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Opposite
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Shock Symptoms
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Decrease BP
Increased Pulse & Respirations |
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IICP Symptoms
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Increase BP
Decreased Pulse & Respirations Cushings Triad |
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CRANIOTOMY POST OP CARE
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NEURO CHECKS EVERY HOUR FIRST 24 HOURS
SUCTION INCREASES ICP-PREOXYGENATE BRADY COMMON-ATROPINE PRIOR VENTILATOR-MAY NEED TO INCREASE RATE TO CONTROL PCO2 NO NG TUBE WITH ASILAR SKULL OR FACIAL FX NO HEAVY NARCOTICS USE MILD NON-OPIATES USE ICE PACKS FOR HA PARALYTICS TO CONSERVE OXYGEN CONSUMPTION ACCUCHECKS SEIZURE PRECAUTIONS (PREOP ANTICONVULSANTS) I AND O BE NON-JUDGEMENTAL W PERSONALITY CHANGES SCDS SPINE ALIGNED HOB 30 DEGREES BONE FLAP = HELMET FREQ REST PERIODS - DECREASES ICP |
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TRANSPHENOIDAL SURGERY CARE
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PROCEDURE TO REMOVE PITUITARY GLAND
INCISION CARE HOB 30 DEGRESS NASAL PACKING; DONT INCREASE PRESSURE NO STRAWS MONITOR O2 SATS-CAN DECREASE WITH MOUTH BREATHING HUMIDIFIED AIR PERSISTENT HA=CSF LEAK-LAY FLAT |
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TRANSPHENOIDAL SX COMPLICATIONS
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HEMORR
CSF LEAK VISUAL IMPAIRMENT DIABETES INSIPIDUS R/T PRESSURE PUT ON PITUITARY/HYPOTHALAMUS RESULTS=INCREASE URINE OUT, INCREASED NA+=RISK FOR DEHYDRATION GIVE FLUIDS GIVE DDAVP DESMOPRESSIN (ANTIDIURETIC, HEMOSTATIC) SIADH DECREASE URINE FLUID RETENTION DECREASE NA+ NEED FLUID RESTRICTION OR 3%NS |
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POST CRANIO MEDS
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MANNITOL-CRYSTALIZES WHEN COLD
PARALYTICS (PAVULON, NORCURON, TRACRIUM)--CALMS THEM DOWN DIPRIVAN (PROPOFOL)-MILK OF AMNESIA USED FOR INDUCTION WATCH FOR RESP DEPRESSION AND MUSCLE TREMORS |
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PVS
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PERSISTENT VEGETATIVE STATE
0 AWARENESS 0 REFLEXES MID BRAIN AND BRAIN STEM STILL WORK |
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BRAIN DEATH
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UNRESPONSIVE TO EXTERNAL STIMULI
ABSENT BRAINSTEM REFLEXES ABSENT RESP EFFORT WITH HYPERCAPNIA |
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ONE OF THE FOLLOWING NEEDED FOR BRAIN DEATH TO BE DETERMINED
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2 EXAMS ATLEAST 6 HOURS APART
2 FLAT EEGS 2 HRS APART 2 INTRANCRANIAL BLOOD FLOW DOPPLER 2 HOURS APART |
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Lumbar Puncture
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opening pressure >200=abnormal
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Post LP
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Lay flat 6-8 hrs (decreases leak of CSF)
quiet dark room may have HA -dont have to call MD for this Replace fluids |
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LP Complications
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headache, nuchal rigidity, irritability, decrease LOC--call MD
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CSF glucose normal
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45-70
less is abnormal bacterial meningitis |
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CSF protein normal
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15-45
more is abnormal subarachnoid hemm? meningitis? |
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Myelogram
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Hold Glucophage before and after
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Myelogram
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12 hour bedrest
watch for seizures no phenothiazines (antipsychotics) for 48 hrs (decreases the risk for seizure) |
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EMG -little needles in muscles
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checks for
Lou Gerig Muscular Dystrophy Myasthenia Gravis |
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ABGS
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decrease PO2, increased ICP
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Osmolality
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285-295
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Critical Osmolality
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<265 or >320
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respiratory arrest at
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360
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death
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>420
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Increased osmolality
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dehydration, hypovolemia
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Increased glucose and Na+
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DI
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DI
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na up, urine up
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siadh
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na down, urine down
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Normal ICP
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10-15
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Abnormal ICP
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greater than 20
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map-icp=
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cpp
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map
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2 x diastolic +systolic divided by 3
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map normal range
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70-110
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map necessary for perfusion
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60
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cpp normal
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70-90
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