Card Set Information

2014-11-21 17:54:31

#11 and #12
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  1. Normal pressure with a transducer
  2. Clinical manifestations of increased ICP
    • #1 decreased LOC
    • BP increases to widen pulse pressure to deteriorated
    • Pulse increases to weak and thready
    • Decorticate and Decerebrate posturing
    • HA
    • N/V
  3. Treatment goal for a person with increased ICP
    to keep pressure below 20
  4. Intraventricular catheter
    put in the right side of the brain to measure ICP
  5. Licox monitor and normal numbers
    put in to ischemic brain tissue to measure O2 levels

  6. Interventions for a person with increased ICP
    • HOB at 30
    • head in neural position
    • Intubation/mech. vent
    • maintain cerebral perfusion
    • mannitol to draw blood from brain cells
    • nutritional therapy
  7. How do you maintain cerebral perfusion
    • fluids
    • keep SBP between 100-160
    • decrease cerebral metabolism by preventing seizures, sedate with propofol and keep patient cool
  8. DVT prophylaxis for a person with increased ICP
  9. Treatment priority for TBI
    • #1 ABC
    • #2 cervical spine precautions
  10. Skull fx
    • monitor neuro
    • monitor loc
    • watch for signs of increased ICP
  11. S/S of basilar skull fx and treatment
    s/s rhinorrhea, ottorhea, battle signs

    treat-control  and treat ICP, position FLAT in bed
  12. Concussion.....monitor?  teach family?
    monitor neuro, LOC, pupil changes, vomiting?, worsening HA

    • teach-wake up and ask hard question
    • assess pupils and LOC q 2h for 24 hrs

    • Tylenol only
    • NO ASA, Sedatives or Alcohol
  13. Contusion...describe and give treatment
    brain bruise ....coup/counter coup...max edema will be 2-4 days after injury....mon. in hospital

    treat-man ABC, control bleeding, watch for increaesd ICP and infections
  14. Lacerations and treatment
    tearing of brain tissue, possible hemorrhage, poor outlook

    trt-ABC, control bleeding, infection?, increased ICP?
  15. Diffuse axonal Injury....and treatment
    seen as dots on a CT, usually from MVA and deceleration

    treat-ABC, ICP control
  16. Hematoma.....and treatment
    brain bleed

    • surgery
    • ABC
    • control bleeding
    • watch ICP
  17. Subarachnoid/Aneurysm
    • control bleeding and ICP
    • seizure precautions
    • aneurysm precautions
    • surgery clip and coil

    Triple H therapy after coil/clip
  18. Triple H therapy after Clip/Coil with aneurysm
    • Hypertensive...keep BP high to increase brain perfusion
    • Hypervolemic....lots of fluid to perfuse the brain
    • Hemodilution....perfuses tissues
  19. Aneurysm precautions
    done pre surgery or if no surgery

    • dim lights
    • limit visitors
    • decrease stimulation
    • elevate HOB 30-45
    • avoid valsalva
    • give sedatives/analgesics
  20. S/S of a brain tumor
    • wake up with a HA...but decreases as walk around
    • N/V
    • seizures
    • Dizziness/vertigo
    • change in mental status
  21. Sequence of tumor....best to worst to have
    • glioma
    • astrocytoma
    • gliobastoma multiforme
  22. Treatment for brain tumors
    • early dx is crucial
    • surgery when possible
    • radiation