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Unit 6-Neuro
Neuro
19
Nursing
Undergraduate 3
03/07/2011

Additional Nursing Flashcards

 


 

Cards

Term

IICP

 

Indications

Definition

Indications are related to location and cause of raised pressure.

Any altertations in LOC

Decrease in Glasgow Coma Scale

Cushing's triad is a late response and indicates severe IICP.

Term

IICP

Treatment Goals

Definition

Maintaining cerebral perfusion

Decrease ICP

Maintain optimal neurological function

Ready for rehabilitation

Term
Osmotic Diuretics
Definition

Mannitol

Immediately expands the volume of plasma and increases cerebral blood flow and oxygen delivery.

Term
Complications of Head Injury
Definition

Cerebral edema

Stress ulcers

Seizures

Infections

Acute hydrocephalus

SIADH

Cardiac dysrhythmias

Neurogenic pulmonary edema

Subarachnoid hemorrhage/aneurysms

Altered behavior

Post-trauma response

Term
Cerebral Edema
Definition
An increase in the fluid content surrounding the tissues of the brain, such as in the extracellular spaces or the white matter, or within the cells.
Term

Cerbral Edema

Treatment

Definition

Osmotic diuretics

Head of bed 30 degrees

Maintain patent airway

Monitor ICP

Term

Cerebral Perfusion Pressure

CPP

Definition

CPP=MAP-ICP

The amount of blood flow from the systemic circulation required to provide adequate oxygen and glucose for brain metabolism.

When ICP and MAP are equal there is no CPP and brain perfusion ceases.

Crucial to maintain control of both ICP and MAP.

CPP goal = remember 70

Term
Causes of IICP
Definition
Cerebral edema and brain swelling
Term
Diffuse Injury
Definition

Brain moves enough to shear or tear axons secondary to trauma. 

Often there is no macroscopic abnormality noted on CT.

Detected on the basis of neuropsychological tests.

Term
Coup Countercoup Injury
Definition
Injury at point of contact and on the opposite side of the skull.
Term
Penetrating Trauma
Definition
Head wounds made by foreign bodies or bone fragments from a skull fracture. Damage done to brain itself or to vessels resulting in a hematoma.
Term
Epidural Hematoma
Definition

Between skull and dura

10% of severe head injuries

Usually associated with skull fractures

Injury to cerebral blood vessels under fracture

Bleeding continues and clot forms, seperating skull from dura.

Term

Epidural Hematoma

Manifestations

and

Prognosis

Definition

Brief period of disrupted consciousness followed by a lucid period which is then followed by a rapidly deteriorating consciousness.

Rapid dx with CT followed by treatment is detrimental as injury is usually minor and with treatment, prognosis is usually good.

Term
Subdural Hematoma
Definition

Between the dura and the outer arachnoid membrane.

Bridging veins, venous blood flow.

Slow formation of hematoma.

 

Term

Subdura Hematoma

Manifestations

Definition

Produces symptoms within 24 hours of injury.

Delayed and patients may not associate them with a head injury.

IICP->headaches, vomiting, blurred vision.

2-10 days after the primary event

dx: CT and MRI

tx: Surgical to remove clot, antibiotics, and seizure prophylaxis.

Term
Medical Managment of TBI
Definition

Anticipate orders for labs, radiology, IVF, Mannitol, anti seizure meds, frequent VS and neuro checks.

 

Assessment:

Glasgow Coma Scale

Check Pupils

Vital Signs

Watch trends and report changes

Term

ICP monitoring

 

 

Definition

Ventriculostomy-monitor and drain CSF if needed

Subarachnoid screw

Subdural/Epidural Catheter

Intraparenchymal of a Fiberoptic Transducer Tipped Catheter

Term
Hypotension and brain injury
Definition

BAD! Often associated with bad outcomes.

Avoid!

Maintain MAP.

Avoid hypotonic fluids.

 

 

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