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?

    <p>To monitor cerebral perfusion</p> Signup and view all the answers

    What is a potential complication of decompressive hemicraniectomy?

    <p>Infection</p> Signup and view all the answers

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

    <p>To increase cardiac output</p> Signup and view all the answers

    What is the proposed benefit of decompressive hemicraniectomy?

    <p>To allow the brain to expand without pressure constraints</p> Signup and view all the answers

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

    <p>To decrease cerebral edema</p> Signup and view all the answers

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

    <p>Increased cerebral blood flow</p> Signup and view all the answers

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

    <p>Increased cerebral blood volume</p> Signup and view all the answers

    What is the definition of cerebral edema?

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

    What is the purpose of autoregulation in the brain?

    <p>To maintain a constant cerebral blood flow during alterations in systemic blood pressure</p> 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?

    <p>50 to 150 mm Hg</p> Signup and view all the answers

    How is cerebral perfusion pressure (CPP) calculated?

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

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

    <p>70 to 100 mm Hg</p> Signup and view all the answers

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

    <p>Decreased CPP</p> Signup and view all the answers

    What is a potential complication of neurosurgical procedure?

    <p>All of the above</p> Signup and view all the answers

    What is the primary focus of maintaining cerebral tissue perfusion?

    <p>Maintaining optimal oxygen levels</p> Signup and view all the answers

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

    <p>Ineffective coping</p> Signup and view all the answers

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

    <p>High risk for impaired skin integrity</p> Signup and view all the answers

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

    <p>Maintaining or restoring neurologic homeostasis</p> Signup and view all the answers

    What is a potential complication of increased ICP?

    <p>Bleeding and hypovolemic shock</p> Signup and view all the answers

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

    <p>Risk for imbalanced body temperature</p> Signup and view all the answers

    What is a potential nursing diagnosis related to neurologic deficit?

    <p>Impaired physical mobility</p> 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.

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