Podcast
Questions and Answers
What is the normal range for intracranial pressure (ICP)?
What is the normal range for intracranial pressure (ICP)?
- 0-5 mmHg
- 10–20 mmHg
- 5-15 mmHg (correct)
- 15-30 mmHg
Which of the following is a hallmark sign of increased intracranial pressure?
Which of the following is a hallmark sign of increased intracranial pressure?
- Hyperreflexia
- Hypotension
- Cushing's triad (correct)
- Tachycardia
Which cranial structure cannot expand and contributes to the risk of increased ICP?
Which cranial structure cannot expand and contributes to the risk of increased ICP?
- Brainstem
- Skull (correct)
- Cerebellum
- Meninges
Select all causes of sustained increased intracranial pressure:
Select all causes of sustained increased intracranial pressure:
What does the Monro-Kellie hypothesis state?
What does the Monro-Kellie hypothesis state?
What value of ICP is considered life-threatening?
What value of ICP is considered life-threatening?
Which formula is used to calculate Cerebral Perfusion Pressure (CPP)?
Which formula is used to calculate Cerebral Perfusion Pressure (CPP)?
What is the normal CPP range?
What is the normal CPP range?
What type of stroke results from bleeding into the brain?
What type of stroke results from bleeding into the brain?
What condition involves excess cerebrospinal fluid accumulation in the brain?
What condition involves excess cerebrospinal fluid accumulation in the brain?
Which of the following is NOT part of Cushing's Triad?
Which of the following is NOT part of Cushing's Triad?
A patient shows flexion of arms, clenched fists, and extended legs. What type of posturing is this?
A patient shows flexion of arms, clenched fists, and extended legs. What type of posturing is this?
Which test is most commonly used to assess level of consciousness in patients with suspected increased ICP?
Which test is most commonly used to assess level of consciousness in patients with suspected increased ICP?
Which pharmacologic agent is used to reduce cerebral edema and lower ICP?
Which pharmacologic agent is used to reduce cerebral edema and lower ICP?
What is the purpose of a ventriculoperitoneal (VP) shunt?
What is the purpose of a ventriculoperitoneal (VP) shunt?
Select all that are potential causes of increased ICP:
Select all that are potential causes of increased ICP:
What type of diagnostic imaging is most commonly used for evaluating increased ICP?
What type of diagnostic imaging is most commonly used for evaluating increased ICP?
Decerebrate posturing indicates damage to what area of the brain?
Decerebrate posturing indicates damage to what area of the brain?
Which of the following would be the priority action in a patient with suspected increased ICP?
Which of the following would be the priority action in a patient with suspected increased ICP?
Which meninges is closest to the brain?
Which meninges is closest to the brain?
What is the function of cerebrospinal fluid (CSF)?
What is the function of cerebrospinal fluid (CSF)?
What percentage of intracranial volume is brain tissue?
What percentage of intracranial volume is brain tissue?
Which surgical procedure permanently removes part of the skull to reduce ICP?
Which surgical procedure permanently removes part of the skull to reduce ICP?
Which is the most critical finding indicating increased ICP in a patient with TBI?
Which is the most critical finding indicating increased ICP in a patient with TBI?
Which finding suggests improvement in a patient receiving mannitol?
Which finding suggests improvement in a patient receiving mannitol?
Select all components of the Monro-Kellie doctrine:
Select all components of the Monro-Kellie doctrine:
What is the purpose of a ventriculostomy?
What is the purpose of a ventriculostomy?
Which GCS score indicates a comatose state?
Which GCS score indicates a comatose state?
Select all appropriate interventions to reduce ICP:
Select all appropriate interventions to reduce ICP:
Which statement best describes decorticate posturing?
Which statement best describes decorticate posturing?
What is the typical volume of CSF in the brain?
What is the typical volume of CSF in the brain?
Which cause of increased ICP is classified as a space-occupying lesion?
Which cause of increased ICP is classified as a space-occupying lesion?
Which brain infection causes inflammation of the meninges?
Which brain infection causes inflammation of the meninges?
Which sign is earliest in increasing ICP?
Which sign is earliest in increasing ICP?
What causes CSF to form?
What causes CSF to form?
What happens when CPP drops below 50 mmHg?
What happens when CPP drops below 50 mmHg?
Select all conditions that could lead to TBI:
Select all conditions that could lead to TBI:
What type of stroke involves a clot blocking blood flow to the brain?
What type of stroke involves a clot blocking blood flow to the brain?
What cranial nerve is tested by pupillary response?
What cranial nerve is tested by pupillary response?
What happens to MAP when blood pressure is 117/79?
What happens to MAP when blood pressure is 117/79?
What is the earliest indicator of neurological deterioration?
What is the earliest indicator of neurological deterioration?
Select all signs of Cushing's triad:
Select all signs of Cushing's triad:
What intervention can most rapidly reduce ICP?
What intervention can most rapidly reduce ICP?
What brain infection affects both the meninges and brain tissue?
What brain infection affects both the meninges and brain tissue?
What is a safe nursing action during a suspected rise in ICP?
What is a safe nursing action during a suspected rise in ICP?
Which space contains CSF in the brain?
Which space contains CSF in the brain?
Which is a type of hemorrhagic stroke?
Which is a type of hemorrhagic stroke?
Which patient condition is most concerning in increased ICP?
Which patient condition is most concerning in increased ICP?
What is a key nursing outcome for a patient with increased ICP?
What is a key nursing outcome for a patient with increased ICP?
What best describes a cranioplasty?
What best describes a cranioplasty?
Flashcards
Normal Intracranial Pressure (ICP)
Normal Intracranial Pressure (ICP)
Normal ICP is typically between 5 and 15 mmHg.
Cushing's Triad
Cushing's Triad
Cushing's triad includes bradycardia, hypertension with widened pulse pressure, and irregular respirations, indicating increased ICP.
Skull's Role in ICP
Skull's Role in ICP
The skull is a rigid, non-expandable structure. Any increase in volume (e.g., blood, CSF, brain tissue) leads to increased ICP.
Causes of Sustained Increased ICP
Causes of Sustained Increased ICP
Signup and view all the flashcards
Monro-Kellie Hypothesis
Monro-Kellie Hypothesis
Signup and view all the flashcards
Life-Threatening ICP
Life-Threatening ICP
Signup and view all the flashcards
Cerebral Perfusion Pressure (CPP) Calculation
Cerebral Perfusion Pressure (CPP) Calculation
Signup and view all the flashcards
Normal CPP Range
Normal CPP Range
Signup and view all the flashcards
Hemorrhagic Stroke
Hemorrhagic Stroke
Signup and view all the flashcards
Hydrocephalus
Hydrocephalus
Signup and view all the flashcards
What is NOT part of Cushing's Triad?
What is NOT part of Cushing's Triad?
Signup and view all the flashcards
Decorticate Posturing
Decorticate Posturing
Signup and view all the flashcards
Glasgow Coma Scale (GCS)
Glasgow Coma Scale (GCS)
Signup and view all the flashcards
Mannitol
Mannitol
Signup and view all the flashcards
Ventriculoperitoneal (VP) Shunt
Ventriculoperitoneal (VP) Shunt
Signup and view all the flashcards
Study Notes
- Normal intracranial pressure (ICP) is between 5 and 15 mmHg
- ICP above 20 mmHg is considered elevated and may require intervention.
- Cushing's triad (bradycardia, hypertension with widened pulse pressure, and irregular respirations) is a late but classic sign of increased ICP.
- The skull, a rigid, non-expandable structure, contributes to the risk of increased ICP because any increase in volume (blood, CSF, brain tissue) can raise pressure.
- Sneezing and coughing cause transient increases in ICP
- Tumors, hydrocephalus, and TBIs cause sustained ICP elevation.
- The Monro-Kellie hypothesis states the brain, CSF, and blood share a fixed cranial space and an increase in one component must be offset by a decrease in another to maintain pressure
- An ICP >40 mmHg is considered life-threatening, indicates severe intracranial hypertension and requires immediate intervention.
- The formula to calculate Cerebral Perfusion Pressure (CPP) is CPP = MAP – ICP where it is used to determine the pressure needed for adequate cerebral blood flow
- Normal CPP is 60–70 mmHg and CPP below 50 mmHg may lead to irreversible damage.
- Hemorrhagic stroke involves bleeding into the brain, often due to vessel rupture.
- Hydrocephalus is characterized by increased CSF accumulation, leading to increased ICP.
- Hyperthermia is not a component of Cushing's Triad where the triad includes hypertension, bradycardia, and irregular respirations.
- Decorticate posturing involves arm flexion and leg extension and indicates lesions above the brainstem.
- The Glasgow Coma Scale (GCS) is used to assess LOC, particularly in neurological or head injury assessments.
- Mannitol, an osmotic diuretic, pulls fluid out of brain tissue to reduce ICP.
- A ventriculoperitoneal (VP) shunt treats hydrocephalus by draining CSF from the ventricles into the peritoneal cavity.
- Brain tumors, hydrocephalus, stroke, and infections like meningitis all increase ICP
- A CT scan is the standard initial imaging for assessing intracranial pathology and increased ICP.
- Decerebrate posturing results from damage to the brainstem and is more severe than decorticate.
- HOB elevation to 30° promotes venous drainage, decreasing ICP, and deep suctioning and Trendelenburg can raise ICP.
- The pia mater is the innermost layer directly covering the brain.
- CSF cushions and protects the CNS, helps with waste removal, and provides nutrients.
- Brain tissue comprises approximately 80% of the intracranial contents, with the rest made up of CSF and blood.
- A craniectomy is the permanent removal of a portion of the skull to relieve pressure.
- Unequal pupils suggest increased pressure on cranial nerves and require urgent evaluation.
- Improved level of consciousness indicates reduced ICP and improved cerebral perfusion.
- The Monro-Kellie hypothesis involves the brain, blood, and CSF within a fixed-volume skull.
- A ventriculostomy is used to monitor ICP and drain CSF as needed.
- A GCS score of 8 or less suggests coma and the need for airway protection and intensive monitoring.
- Head elevation, normothermia, and oxygenation help reduce ICP, while neck flexion and Trendelenburg can worsen it.
- Decorticate posturing involves flexion of the upper limbs and indicates damage above the brainstem.
- The average adult has 100–150 mL of CSF, which is continuously circulated and reabsorbed.
- A glioblastoma is a brain tumor that physically occupies space, increasing ICP.
- Meningitis is an inflammation of the meninges, increasing ICP through inflammation and edema.
- A change in level of consciousness is often the earliest and most sensitive indicator of increased ICP.
- CSF is formed in the choroid plexuses located within the brain's ventricles.
- A CPP <50 mmHg leads to insufficient perfusion and possible irreversible brain damage.
- MVAs, assaults, and falls are common causes of traumatic brain injury
- Ischemic strokes are caused by blockages, usually due to a thrombus or embolus.
- CN III (oculomotor nerve) controls pupil constriction, and compression may cause dilation.
- The MAP = [(2×diastolic) + systolic]/3
- LOC changes are the most sensitive and earliest sign of worsening neurological function.
- Cushing's triad = HTN, bradycardia, and irregular respirations.
- Mannitol has a rapid onset and works within minutes to reduce cerebral edema.
- Encephalitis involves brain tissue inflammation, while meningitis affects just the meninges.
- Reduce stimulation and monitor to avoid further increasing ICP.
- CSF circulates in the subarachnoid space between the arachnoid and pia mater.
- Subarachnoid hemorrhage is a form of hemorrhagic stroke caused by ruptured vessels.
- A fixed, dilated pupil may indicate herniation—a medical emergency.
- CPP > 60 mmHg ensures sufficient cerebral perfusion and oxygenation.
- Cranioplasty is the repair of the skull after a prior craniectomy once swelling has decreased.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
