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2 Nd Icp

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  • 1. ncreased Intracranial Pressure
  • 2. It is an increased in normal brain pressure due to increases cerebrospinal fluid pressure. Also, maybe d/t increased pressure within the brain matter caused by lesions or swelling. ncreased Intracranial Pressure
  • 3. Head injury / Secondary effects ↓ Cerebral perfusion ↓ Swelling (edema) ↓ Shifting of brain tissue ↓ Herniation Pathophysiology
  • 4. Cerebral Edema
    • Abnormal accumulation of water/fluid in the intra or extra cellular space, associated with an increase in brain tissue volume.
  • 5. Autoregulation
    • One of several mechanisms of brain that attempt to compensate of the increasing ICP.
    • The ability of the brain to change the diameter of its blood vessels automatically to maintain a constant cerebral blood flow during alteration in systemic blood pressure.
  • 6. Cerebral Response to Increased ICP
    • As ICP rises, compensatory much in the brain work to maintain blood flow and prevent tissue damage.
    • Cushing response (Cushing reflex)
    • - When cerebral blood flow decreased significantly.
    • Cushing triad
    • - Bradycardia
    • - Bradypnea
    • - Hypertension
  • 7.
    • MRI
    DIAGNOSIS
  • 8.  
  • 9.
    • bulging fontanelle
    • separated suture
    • lethargy
    • vomiting
    Symptoms
  • 10.
    • Headache
    • changes in behavior
    • progressive decreased consciousness
    • neurologic deficit
    • seizures
    Symptoms
  • 11.  
  • 12. Management
    • Ventriculostomy
    • Subarachnoid bolt
    • Epidural monitor
    • Fiberoptic monitor
  • 13.  
  • 14.  
  • 15.  
  • 16. Decreasing Cerebral Edema
    • Osmotic Diuretics (Mannitol)
    • Corticosteroids (Dexamethasone)
    • Fluid restriction
  • 17. Other management
    • Diet: withhold foods and fluids as ordered.
    • I.V. therapy: electrolyte replacement, saline lock.
    • Oxygen therapy.
    • Intubation and mechanical ventilation with hyperventilation.
    • GI decompression: NG tube.
    • Position: semi-Fowler’s.
  • 18.
    • Diuretics: Mannitol, Furosemide. > Antacids: Magnesium and Aluminum hydroxyde > Anticonvulsants: Phenytoin > Glucocorticoids: Dexamethasone > Histamine antagonist: Cimetidine, Ranitidine > Barbiturate- i nduced coma or sedation
    MEDICATIONS
  • 19.
    • Maintain fluid restriction.
    • Administer I.V. fluid as prescribed.
    • Administer Oxygen as prescribed.
    • Suction only as needed.
    • Assist with turning, coughing and deep breath.
    • Turn the patient every 2 hours.
    • Administer meds as prescribed.
    • Maintain a quiet environment.
    NURSING INTERVENTIONS
  • 20. COMPLICATIONS
    • Brainstem herniation
    • Diabetes InsipiduS
    • SIADH
    • Coma
    • Death

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