Podcast
Questions and Answers
What is the expected reference range for intracranial pressure (ICP)?
What is the expected reference range for intracranial pressure (ICP)?
Which of the following actions can lead to an increase in ICP?
Which of the following actions can lead to an increase in ICP?
What position should the head be maintained to help decrease ICP?
What position should the head be maintained to help decrease ICP?
Which measure should be avoided to prevent an increase in ICP?
Which measure should be avoided to prevent an increase in ICP?
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During the first 24 hours following a head injury, hyperventilation should be approached with caution because it can cause which condition?
During the first 24 hours following a head injury, hyperventilation should be approached with caution because it can cause which condition?
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What effect does hypercarbia have on intracranial pressure (ICP)?
What effect does hypercarbia have on intracranial pressure (ICP)?
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Which action should be implemented to promote venous drainage and reduce ICP?
Which action should be implemented to promote venous drainage and reduce ICP?
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What is a recommended practice to maintain a patent airway in a client with increased ICP?
What is a recommended practice to maintain a patent airway in a client with increased ICP?
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Which patient care practice should be avoided in a patient with increased intracranial pressure?
Which patient care practice should be avoided in a patient with increased intracranial pressure?
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What should be considered during the first 24 hours following a head injury concerning hyperventilation?
What should be considered during the first 24 hours following a head injury concerning hyperventilation?
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What is a primary purpose of performing a craniotomy?
What is a primary purpose of performing a craniotomy?
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What is a critical nursing action after a supratentorial craniotomy?
What is a critical nursing action after a supratentorial craniotomy?
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Which of the following conditions can arise from a brain herniation?
Which of the following conditions can arise from a brain herniation?
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Which medication can be used postoperatively to help prevent seizure activity?
Which medication can be used postoperatively to help prevent seizure activity?
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What role does interprofessional care play in the recovery of a patient after a craniotomy?
What role does interprofessional care play in the recovery of a patient after a craniotomy?
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What is associated with a craniotomy that may impact patient outcomes?
What is associated with a craniotomy that may impact patient outcomes?
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How can the risk of intracranial hemorrhages be managed during treatment?
How can the risk of intracranial hemorrhages be managed during treatment?
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What is the expected patient positioning following an infratentorial craniotomy?
What is the expected patient positioning following an infratentorial craniotomy?
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What is the primary treatment for brain herniation if urgent medical intervention is required?
What is the primary treatment for brain herniation if urgent medical intervention is required?
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What sign indicates a deteriorating level of consciousness associated with brain herniation?
What sign indicates a deteriorating level of consciousness associated with brain herniation?
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In managing a client with diabetes insipidus after brain surgery, which action is crucial for monitoring?
In managing a client with diabetes insipidus after brain surgery, which action is crucial for monitoring?
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What is likely the most severe complication of mannitol treatment?
What is likely the most severe complication of mannitol treatment?
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Which nursing action is essential for family members of a client experiencing brain herniation?
Which nursing action is essential for family members of a client experiencing brain herniation?
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What is a common symptom indicating the need for surgical intervention in cases of hematoma?
What is a common symptom indicating the need for surgical intervention in cases of hematoma?
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How should fluid balance be monitored in clients undergoing treatment for diabetes insipidus?
How should fluid balance be monitored in clients undergoing treatment for diabetes insipidus?
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Which abnormal respiratory pattern may be observed in patients experiencing brain herniation?
Which abnormal respiratory pattern may be observed in patients experiencing brain herniation?
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What is the primary action of mannitol in the treatment of cerebral edema?
What is the primary action of mannitol in the treatment of cerebral edema?
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What is a primary concern when using barbiturates for inducing a coma in patients with increased ICP?
What is a primary concern when using barbiturates for inducing a coma in patients with increased ICP?
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Which nursing action is essential when administering phenytoin?
Which nursing action is essential when administering phenytoin?
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What is a significant risk associated with the use of opioids in patients not on mechanical ventilation?
What is a significant risk associated with the use of opioids in patients not on mechanical ventilation?
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What is the recommended action if a patient becomes overmedicated with opioids?
What is the recommended action if a patient becomes overmedicated with opioids?
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Study Notes
Increased Intracranial Pressure (ICP) Monitoring
- ICP is monitored by placing a device (screw, catheter, or sensor) through a burr hole into the ventricle or a surrounding space (subarachnoid, epidural, or subdural).
- Normal ICP is 10-15 mm Hg.
ICP-Increasing Factors
- Hypercarbia (increased CO2) causing cerebral vasodilation
- Endotracheal or oral suctioning
- Coughing
- Extreme neck or hip flexion/extension
- Head of bed less than 30°
- Increased intra-abdominal pressure (e.g., tight clothing, Valsalva maneuver)
Decreasing ICP
- Elevate the head of the bed at least 30 degrees. This reduces ICP and promotes venous drainage.
- Avoid extreme head movements (flexion, extension, or rotation). Maintain the body in a neutral midline position.
- Maintain a clear airway. Mechanical ventilation might be needed.
- Administer oxygen to keep PaO2 above 60 mm Hg.
- Provide stool softeners and discourage the Valsalva maneuver.
- Maintain a calm, quiet environment. (Limit visitors, minimize noise).
Hyperventilation and ICP
- Brief periods of hyperventilation may lower ICP after the first 24 hours post-injury for intubated clients.
- During the first 24 hours, hyperventilation can cause cerebral vasoconstriction, potentially leading to ischemia if not monitored carefully.
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Description
This quiz covers the essentials of monitoring increased intracranial pressure (ICP), including normal ranges and factors that can affect ICP. It also addresses methods for decreasing ICP effectively. Learn the best practices and interventions for managing this critical condition.
