Brain Injury/ICP

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  1. What are the components of ICP?
    • Brain tissue
    • Blood
    • Cerebrospinal Fluid
  2. What is the normal ICP range?
    0-15 mm Hg
  3. What are the two requirements for the brain?
    • Oxygen
    • Glucose
  4. What is the most important assessment for increasing ICP?
    What are other findings?
    LEVEL OF CONSCIOUSNESS

    • Headache and Vomiting
    • Blown pupil (CN III)
    • Cushing's Triad
    • Decorticate posturing
    • Decerebrate posturing
  5. What can increase ICP?
    • Hemorrhage
    • Tumors
    • Meninigitis
    • Encephalitis
    • Hydrocephalus
    • Hyponatremia
  6. Increase or Decrease for aggravating factors of:
    PCO2
    PO2
    pH
    Increase

    Decrease

    Decrease
  7. What osmotic diuretic draws fluid out of the brain tissue?
    Mannitol
  8. What is associtated with a dural tear and has signs of CSF leakage from the nose or ear?
    Basilar Skull Fracture
  9. Epidural Hematoma:
    Where's the bleed?
    Arterial or Venous?
    Progression?
    Treatment?
    Between skull and dura mater

    Arterial

    • Unconscious
    • Lucidity
    • Decrease LOC, Vomit, Focal deficits

    Emergent surgical evacuation
  10. Subdural Hematoma:
    Where's the bleed?
    Arterial or Venous?
    Progression?
    Treatment?
    Between dura and arachnoid mater

    Venous

    Increase ICP and neuro symptoms

    Surgical evacuation
  11. Subdural Hematoma:
    Acute vs Subacute vs Chronic
    Acute: 24-48 hours

    Subacute: 2 days-2 weeks

    Chronic: Weeks to months
  12. Emergent care for head injuries?
    • ABC
    • Stabilize C-Spine
    • Control bleed
    • Assess for CSF leak
    • Vitals
    • Seizure precautions
  13. What are the primary brain tumors?
    • Menigioma
    • Acoustic neuroma
    • Pituitary adenoma
    • Astrocytoma (malignant)
    • Glioblastoma multiforme (the worst)
  14. What is the diagnostic test of choice for a brain tumor?
    What is the surgery treatment of choice?
    MRI

    Complete resection or debulking
  15. What is the priority assessment for post craniotomy?
    Monitor for and prevent increased ICP
  16. What is the function of Dexamethasone (Decadron) in a post craniotomy?
    To prevent cerebral edema
  17. Brudzinski's Sign vs Kernig's Sign
    Brudzinski - Can't flex neck back

    Kernig - Can't flex hip
  18. A 42y/o male is in the neuro ICU after a closed head injury. The patient's blood pressure is 150/90. Which of the following actions should the nurse take?

    A) Notify the physician
    B) Document the finding and continue to observe the patient
    C) Lay the patient flat to decrease the BP
    D) Administer Nifedipine per protocol to lower the BP
    B) Document the finding and continue to observe the patient
    (this multiple choice question has been scrambled)
  19. A 58y/o female is on the neurology ward after a craniotomy for brain tumor resection. Whic of the following assessments is the MOST important for the nurse to make?

    A) Level of consciousness
    B) Condition of the incision
    C) Pupillary reaction
    D) Skin condition
    A) Level of consciousness
    (this multiple choice question has been scrambled)
  20. The nurse is caring for a patient with increased ICP. Which of the following assessments is MOST significant?
    A) Hemoglobin of 11 g/dl
    B) White Blood Cell Count 13,000
    C) Serum Potassium of 3.4 mEq/dl
    D) Serum Sodium of 119 mEq/dl
    D) Serum Sodium of 119 mEq/dl

    (hyponatremic)
    (this multiple choice question has been scrambled)

Card Set Information

Author:
 wiscflor
ID:
 12112
Filename:
 Brain Injury/ICP
Updated:
2010-03-27 03:21:14
Tags:
MS2 Exam 3
Folders:

Description:
BI ICP
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