NUR 108 Exam 4
- Increased Intracranial Pressure
Answer •sustained elevated pressure e15 mmHg in cranial cavity
• cerebral edema most common cause
- ‘Brain Volume
Answer •‘ amount of tissue
• caused by brain tumors (benign or malignant)
- ‘Cerebral Blood Volume
Answer •subdural hematoma
• space occupying lesion
4. ‘CSF
Answer •obstruction of outflow, overproduction, or “ drainage
• hydrocephalus • shunt, ETV
- Cerebral Edema
Answer *‘ in interstitial fluid from acute brain swelling*
• too much water ’ low Na+ 1 / 3
*‘ in BP pushes fluid out of vessels* • hypertensive crisis *cytotoxic or hypotonic insult at cellular level triggers inflammatory response* • meningitis or stroke *triggered by ‘ in altitude
- Cerebral Angiography
Answer •x-ray images of blood vessels in and around brain
• uses contrast dye • no metformin 48 hrs before procedures
- Computerized Tomography
Answer •medical imaging using computer processed x-rays taken from different angles
• can use contrast • no metformin 48 hrs before procedure if using contrast dye
- Lumbar Puncture
Answer •needle is inserted into spinal canal to collect CSF for diag- nostic testing
• shouldn't be performed if IICP is suspected • sudden release of pressure in skull may cause cerebral herniation
- Electrocephalography (EEG)
Answer •detects electrical activity in brain
- Magnetic Resonance Imaging
Answer •medical imaging using strong magnetic fields to generate images 2 / 3
- Glasgow Coma Scale Categories
Answer • eyes
• verbal • motor
12. IICP S/S
Answer *Early*
• LOC changes * • confusion * • drowsiness • visual deficits
• photophobia • motor weakness • pupil abnormalities • restless w/o apparent cause * *Late* • coma • loss of deep tendon reflexes • positive Babinski's (spread toes) • hyperthermia • loss of brain stem reflexes • Cushing's triad (HTN, bradycardia, bradypnea) • posturing
- IICP Nursing Interventions
Answer •assess LOC, behavior, motor/sensory fxn, pupil reactions, resp. pattern every hr
• monitor ABG results • avoid activities increasing ICP • prevent bladder distention & constipation • maintain HOB @ 30°
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