Term
| What are the three components of ICP? |
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Definition
| Brain, Blood, CSF in the skull and spinal sac. |
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Term
| Draining blood from the brain: which vein drains primarily while supine? standing? |
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Definition
| Supine=internal jugular. Standing=verterbral + internal jugular |
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Term
| What is normal adult/child ICP standing? lying down? infants? |
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Definition
| 5-10 standing, MAYBE 15 lying down, 5-10 for infants. |
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Term
| What is the goal of nursing interventions RE management of ICP? |
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Definition
| Minimizing swelling, ischemia and hypoxia of the brain. |
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Term
| What are the dangers of PYREXIA (fever) rt ICP? |
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Definition
| Increased temp increases CBV and CBF and metabolism of glucose |
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Term
| What are the main compensatory mechanisms the body uses to maintain ICP? |
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Definition
| Decrease CSF production, increase absorption of CSF (small amt vasodilation but MOSTLY CSF management) |
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Term
| What is ADAPTIVE CAPACITY? |
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Definition
| Brain's system reserve available for adaptation to increases in tissue/blood/CSF |
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Term
| How do you calculate CPP? MAP? |
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Definition
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Term
| What is CPP? What are normal adult values? MINIMUM? |
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Definition
| Balance btw systemic and intracranial blood pressure. 60-100, 50-60 min. |
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Term
| What is the autoregulatory response to decreased systemic blood pressure (HYPOTENSION)? |
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Definition
| Blood vessels dilate to decrease resistance and preserve CBF. |
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Term
| What is the autoregulatory response to INCREASED systemic blood pressure (HTN)? |
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Definition
| Blood vessels CONSTRICT to increase resistance and preserve CBF. |
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Term
| Normal vales for CPP? MAP? |
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Definition
Normal is 60-100, minimum is 50-60.
MAP 50-150 |
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Term
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Definition
| ease of distension or deformation “squashiness” |
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Term
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Definition
| The amount of recoil after distension or compression (stiffness) |
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Term
| Average CBF value during autoregulation is: |
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Definition
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Term
| What is the effect of PaO2 on CBF? |
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Definition
| At or above PaO2 50 maintains a constant CBF of about 50. |
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Term
| What is the effect of changes in PaCO2 on CBF? What can a pt do to LOWER PaCO2? |
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Definition
| Changes in PaCO2 have a constant direct effect on CBF; hyperventilate to bring it down. |
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Term
| What are the most consistent factors that increase ICP in nursing care? |
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Definition
| Turning the head and lateral flexion of the head |
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Term
| What are the acute indicators specific to acute ICP? |
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Definition
| Measuring CSF pressure, changes in level of arousal or conciousness, bulging or tense fontanel in infant--all other signs are indicators of worsening neurological status and are often independent of the level of ICP |
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Term
| What are the indicators specific to CHRONIC ICP? |
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Definition
| Measure the CSF Pressure, changes in level of arousal/conciousness, distended scalp veins, enlarged head (child) |
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Term
| What is CUSHING's TRIAD? What is it a sign of? |
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Definition
| Systolic HTN, bradycardia, irregular breathing--it is a sign of impending brain herniation NOT NECESSARILY a sign of the state of ICP |
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Term
| What are indicators of worsening neurological status and NOT necessarily increasing ICP? |
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Definition
| Cushing's Triad, changes in LOC, reflexes, papilledema, papillary response (CN3-4-6) |
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Term
| What are the two responses to the "STERNAL RUB" at the elbow and which is more severe on GCS? |
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Definition
| Decorticate (3) or decerebrate (2), decerebrate is more severe (extension) |
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Term
| What are 4 interventions for CPP management? |
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Definition
| 1. Maintaining adequate BP 2. treatment of increased ICP 3. maintain adequate oxygenation 4. consider postural and Ns care influeances on BP and ICP |
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Term
| What are the prioritized Ns interventions for TBI? |
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Definition
| #1 Reduce ICP and maintain CBF (HOB@30degrees) #2 Oxygenation and ventilation #3 Maintain body temp |
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Term
| What drugs can modify secondary injury cascade for ICP? |
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Definition
| Corticosteroids (only w. brain tumor), free radical inhibitors, Ca Channel Blockers |
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