Cerebral Blood Flow Regulation

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Questions and Answers

What is the proposed benefit of induced hypothermia on the brain?

Increase cardiac output

Decrease oxygen and metabolic requirements (correct)

Increase cerebral edema

Increase intracranial pressure

What is the goal of maintaining cardiac output in patients with neurologic injuries?

Decrease cardiac output

Reduce cerebral perfusion

Maintain cerebral perfusion (correct)

Increase cardiac output

What is the target value for cerebral perfusion pressure (CPP)?

Less than 70 mm Hg

Less than 50 mm Hg

Greater than 50 mm Hg

Greater than 70 mm Hg (correct)

What is the purpose of SjvO2 and Licox monitoring?

To monitor cerebral perfusion Signup and view all the answers

What is a potential complication of decompressive hemicraniectomy?

Infection Signup and view all the answers

What is the goal of fluid volume and inotropic agents in maintaining cerebral perfusion?

To increase cardiac output Signup and view all the answers

What is the proposed benefit of decompressive hemicraniectomy?

To allow the brain to expand without pressure constraints Signup and view all the answers

What is the purpose of induced hypothermia in patients with neurologic injuries?

To decrease cerebral edema Signup and view all the answers

What is the effect of increased PaCO2 on cerebral blood flow?

Increased cerebral blood flow Signup and view all the answers

What is the result of decreased venous outflow in the brain?

Increased cerebral blood volume Signup and view all the answers

What is the definition of cerebral edema?

An abnormal accumulation of water or fluid in the intracellular space, extracellular space, or both Signup and view all the answers

What is the purpose of autoregulation in the brain?

To maintain a constant cerebral blood flow during alterations in systemic blood pressure Signup and view all the answers

What is the range of arterial systolic blood pressure that allows the brain to maintain a steady perfusion pressure?

50 to 150 mm Hg Signup and view all the answers

How is cerebral perfusion pressure (CPP) calculated?

By subtracting the ICP from the mean arterial pressure (MAP) Signup and view all the answers

What is the normal range of cerebral perfusion pressure (CPP)?

70 to 100 mm Hg Signup and view all the answers

What is the result of increased ICP on cerebral perfusion pressure (CPP)?

Decreased CPP Signup and view all the answers

What is a potential complication of neurosurgical procedure?

All of the above Signup and view all the answers

What is the primary focus of maintaining cerebral tissue perfusion?

Maintaining optimal oxygen levels Signup and view all the answers

Which of the following nursing diagnoses is related to sensory perception changes?

Ineffective coping Signup and view all the answers

What is a potential nursing diagnosis related to immobility and pressure?

High risk for impaired skin integrity Signup and view all the answers

What is the primary goal of nursing interventions for the patient?

Maintaining or restoring neurologic homeostasis Signup and view all the answers

What is a potential complication of increased ICP?

Bleeding and hypovolemic shock Signup and view all the answers

What is a potential nursing diagnosis related to damage to the hypothalamus?

Risk for imbalanced body temperature Signup and view all the answers

What is a potential nursing diagnosis related to neurologic deficit?

Impaired physical mobility Signup and view all the answers

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.