Podcast
Questions and Answers
What is the proposed benefit of induced hypothermia on the brain?
What is the proposed benefit of induced hypothermia on the brain?
What is the goal of maintaining cardiac output in patients with neurologic injuries?
What is the goal of maintaining cardiac output in patients with neurologic injuries?
What is the target value for cerebral perfusion pressure (CPP)?
What is the target value for cerebral perfusion pressure (CPP)?
What is the purpose of SjvO2 and Licox monitoring?
What is the purpose of SjvO2 and Licox monitoring?
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What is a potential complication of decompressive hemicraniectomy?
What is a potential complication of decompressive hemicraniectomy?
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What is the goal of fluid volume and inotropic agents in maintaining cerebral perfusion?
What is the goal of fluid volume and inotropic agents in maintaining cerebral perfusion?
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What is the proposed benefit of decompressive hemicraniectomy?
What is the proposed benefit of decompressive hemicraniectomy?
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What is the purpose of induced hypothermia in patients with neurologic injuries?
What is the purpose of induced hypothermia in patients with neurologic injuries?
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What is the effect of increased PaCO2 on cerebral blood flow?
What is the effect of increased PaCO2 on cerebral blood flow?
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What is the result of decreased venous outflow in the brain?
What is the result of decreased venous outflow in the brain?
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What is the definition of cerebral edema?
What is the definition of cerebral edema?
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What is the purpose of autoregulation in the brain?
What is the purpose of autoregulation in the brain?
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What is the range of arterial systolic blood pressure that allows the brain to maintain a steady perfusion pressure?
What is the range of arterial systolic blood pressure that allows the brain to maintain a steady perfusion pressure?
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How is cerebral perfusion pressure (CPP) calculated?
How is cerebral perfusion pressure (CPP) calculated?
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What is the normal range of cerebral perfusion pressure (CPP)?
What is the normal range of cerebral perfusion pressure (CPP)?
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What is the result of increased ICP on cerebral perfusion pressure (CPP)?
What is the result of increased ICP on cerebral perfusion pressure (CPP)?
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What is a potential complication of neurosurgical procedure?
What is a potential complication of neurosurgical procedure?
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What is the primary focus of maintaining cerebral tissue perfusion?
What is the primary focus of maintaining cerebral tissue perfusion?
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Which of the following nursing diagnoses is related to sensory perception changes?
Which of the following nursing diagnoses is related to sensory perception changes?
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What is a potential nursing diagnosis related to immobility and pressure?
What is a potential nursing diagnosis related to immobility and pressure?
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What is the primary goal of nursing interventions for the patient?
What is the primary goal of nursing interventions for the patient?
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What is a potential complication of increased ICP?
What is a potential complication of increased ICP?
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What is a potential nursing diagnosis related to damage to the hypothalamus?
What is a potential nursing diagnosis related to damage to the hypothalamus?
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What is a potential nursing diagnosis related to neurologic deficit?
What is a potential nursing diagnosis related to neurologic deficit?
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Study Notes
Regulation of Cerebral Blood Flow
- Increase in PaCO2 causes cerebral vasodilation, leading to increased cerebral blood flow and ICP
- Decrease in PaCO2 has a vasoconstrictive effect, limiting blood flow to the brain
- Decreased venous outflow may also increase cerebral blood volume, raising ICP
Cerebral Edema
- Abnormal accumulation of water or fluid in the intracellular space, extracellular space, or both
- Associated with an increase in the volume of brain tissue
- Edema can occur in the gray, white, or interstitial matter
- Compensatory mechanisms include autoregulation and decreased production and flow of CSF
Cerebral Response to Increased Intracranial Pressure
- Brain can maintain a steady perfusion pressure if the arterial systolic blood pressure is 50-150 mm Hg and the ICP is less than 40 mm Hg
- Changes in ICP are closely linked with cerebral perfusion pressure (CPP)
- CPP is calculated by subtracting the ICP from the mean arterial pressure (MAP)
Hypothermia and ICP
- Lowering body temperature may decrease cerebral edema by reducing oxygen and metabolic requirements of the brain
- Induced hypothermia has not consistently been shown to be beneficial for patients with brain injury
Maintaining Cerebral Perfusion
- Cardiac output may be manipulated to provide adequate perfusion to the brain
- Improvements in cardiac output are made using fluid volume and inotropic agents
- Effectiveness of cardiac output is reflected in the CPP, which is maintained at greater than 70 mm Hg
Nursing Diagnoses
- Risk for ineffective cerebral tissue perfusion related to cerebral edema
- Risk for imbalanced body temperature related to damage to the hypothalamus, dehydration, and infection
- Potential for impaired gas exchange related to hypoventilation, aspiration, and immobility
Collaborative Problems/Potential Complications
- Increased ICP
- Bleeding and hypovolemic shock
- Fluid and electrolyte disturbances
- Infection
- CSF leak
- Seizures
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Description
This quiz covers the role of carbon dioxide in regulating cerebral blood flow, including the effects of increased and decreased PaCO2 on cerebral blood flow and ICP.