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35 Cards in this Set
- Front
- Back
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Blood flow to brain per minute
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50ml
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% of blood volume the brain uses
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20%
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The brain uses what % of bodies glucose
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25%
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Increase in the volume of the cranial contents (e.g. brain, blood or cerebrospinal fluid), will elevate intracranial pressure. Further, if one of these three elements increase in volume, it must occur at the expense of volume of the other two elements
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Monro-Kellie doctrine
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Normal ICP
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0-15 mm Hg
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Normal Cerebral Perfusion Pressure
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70 - 100 mm Hg
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At what point with increased ICP should the Dr. be contacted?
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If ICP is sustained at 20 or > for 5 minutes
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Most common type of cerebral edema that occurs mainly in the white matter and is attributed to to changes in the endothelial lining of the cerebral capillaries
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Vasogenic Cerebral Edema
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Edema that develops from destructive lesions or trauma to brain tissue resulting in cerebral hypoxia or anoxia
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Cytotoxic edema
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Periventricualr diffusion of ventricular CSF in a pt with uncontrolled hydrocephalus
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Interstitial edema
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Major indicator of ICP
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LOC
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Decreased RR and HR w/ increased Bp
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Cushing's triad
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Pupils will dilate on which side with ICP
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Effected side
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Clinical manifestations of ICP
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LOC
Cushing's triad dilitation of pupils (slow or no response to light) decresed motor function HA, vomitting increased temp seizures |
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Stage 1
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pt is normal
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Stage 2
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increased pressure in brain
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Stage 3
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Cushing's triad
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Stage 4
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Continued pressure increase to lethal level
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Gold standard for ICP Dx
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CT scan
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What is EEG used to monitor in coma pts
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seizures
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Ventricular catheter is placed into the ventricles, fluid-filled spaces within the brain, and drains cerebrospinal fluid (CSF) externally
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Ventriculostomy
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What mechanism is used to drain ICP pressure, and where is the placement of the drain
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Drains to gravity and placement is 15 sonemeters above the ear
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What are the complications of ICP monitoring and draining
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Infection
Collapse Herniation |
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Draining more that 20ml per hr will cause
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Ventricle collapse
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Not draining enough fld could cause
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Herniation
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Normal amount of CSF
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90-150ml
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Collaborative care of ICP
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Identify cause and Tx
support brain func maintain adequate 02 Rx therapy Nutrition support |
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Rx Tx for ICP
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Mannitol
Decadron - dexamethasone Nembutal - pentobarbital |
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What to watch for in pts taking Mannitol
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Na levels could increase
do not use with renal problems |
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Rx that controls vasogenic effect of tumors and abscesses
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Decadron
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% of nutrition a paralyzed or comatose pt needs
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100%
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ICP pts nutritional needs must be met with in how many days
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3
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A pt scoring an 8 or below on the Glasgow scale needs what
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Vent assist
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Neurological checks include which cranial nerves
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3,4,5,6,and 7
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Nursing Management for ICP pt
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Maintain patent airway
NG tube to reduce abd distention pain manage strict I and O ICP monitoring Body position moisture to eyes adequate hygiene oral care Q4 hr decrease stimuli Foley care |
