ncreased Intracranial Pressure
It is an increased in normal brain pressure due to increases cerebrospinal fluid pressure. Also, maybe d/t increased press...
Head injury / Secondary effects ↓ Cerebral perfusion ↓ Swelling (edema) ↓ Shifting of brain tissue ↓ Herniation Pathophysi...
Cerebral Edema <ul><li>Abnormal accumulation of water/fluid in the intra or extra cellular space, associated with an incre...
Autoregulation <ul><li>One of several mechanisms of brain that attempt to compensate of the increasing ICP. </li></ul><ul>...
Cerebral Response to Increased ICP <ul><li>As ICP rises, compensatory much in the brain work to maintain blood flow and pr...
<ul><li>MRI </li></ul>DIAGNOSIS
 
<ul><li>bulging fontanelle </li></ul><ul><li>separated suture </li></ul><ul><li>lethargy </li></ul><ul><li>vomiting </li><...
<ul><li>Headache </li></ul><ul><li>changes in behavior </li></ul><ul><li>progressive decreased consciousness </li></ul><ul...
 
Management <ul><li>Ventriculostomy  </li></ul><ul><li>Subarachnoid bolt </li></ul><ul><li>Epidural monitor </li></ul><ul><...
 
 
 
Decreasing Cerebral Edema <ul><li>Osmotic Diuretics (Mannitol) </li></ul><ul><li>Corticosteroids (Dexamethasone) </li></ul...
Other   management <ul><li>Diet: withhold foods and fluids as ordered. </li></ul><ul><li>I.V. therapy: electrolyte replace...
<ul><li>Diuretics:  Mannitol, Furosemide. >  Antacids:  Magnesium and Aluminum hydroxyde >  Anticonvulsants:  Phenytoin > ...
<ul><li>Maintain fluid restriction. </li></ul><ul><li>Administer I.V. fluid as prescribed. </li></ul><ul><li>Administer Ox...
COMPLICATIONS <ul><li>Brainstem herniation </li></ul><ul><li>Diabetes InsipiduS </li></ul><ul><li>SIADH </li></ul><ul><li>...
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2 Nd Icp

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2 Nd Icp

  1. 1. ncreased Intracranial Pressure
  2. 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. 3. Head injury / Secondary effects ↓ Cerebral perfusion ↓ Swelling (edema) ↓ Shifting of brain tissue ↓ Herniation Pathophysiology
  4. 4. Cerebral Edema <ul><li>Abnormal accumulation of water/fluid in the intra or extra cellular space, associated with an increase in brain tissue volume. </li></ul>
  5. 5. Autoregulation <ul><li>One of several mechanisms of brain that attempt to compensate of the increasing ICP. </li></ul><ul><li>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. </li></ul>
  6. 6. Cerebral Response to Increased ICP <ul><li>As ICP rises, compensatory much in the brain work to maintain blood flow and prevent tissue damage. </li></ul><ul><li>Cushing response (Cushing reflex) </li></ul><ul><li>- When cerebral blood flow decreased significantly. </li></ul><ul><li>Cushing triad </li></ul><ul><li>- Bradycardia </li></ul><ul><li>- Bradypnea </li></ul><ul><li>- Hypertension </li></ul>
  7. 7. <ul><li>MRI </li></ul>DIAGNOSIS
  8. 9. <ul><li>bulging fontanelle </li></ul><ul><li>separated suture </li></ul><ul><li>lethargy </li></ul><ul><li>vomiting </li></ul>Symptoms
  9. 10. <ul><li>Headache </li></ul><ul><li>changes in behavior </li></ul><ul><li>progressive decreased consciousness </li></ul><ul><li>neurologic deficit </li></ul><ul><li>seizures </li></ul>Symptoms
  10. 12. Management <ul><li>Ventriculostomy </li></ul><ul><li>Subarachnoid bolt </li></ul><ul><li>Epidural monitor </li></ul><ul><li>Fiberoptic monitor </li></ul>
  11. 16. Decreasing Cerebral Edema <ul><li>Osmotic Diuretics (Mannitol) </li></ul><ul><li>Corticosteroids (Dexamethasone) </li></ul><ul><li>Fluid restriction </li></ul>
  12. 17. Other management <ul><li>Diet: withhold foods and fluids as ordered. </li></ul><ul><li>I.V. therapy: electrolyte replacement, saline lock. </li></ul><ul><li>Oxygen therapy. </li></ul><ul><li>Intubation and mechanical ventilation with hyperventilation. </li></ul><ul><li>GI decompression: NG tube. </li></ul><ul><li>Position: semi-Fowler’s. </li></ul>
  13. 18. <ul><li>Diuretics: Mannitol, Furosemide. > Antacids: Magnesium and Aluminum hydroxyde > Anticonvulsants: Phenytoin > Glucocorticoids: Dexamethasone > Histamine antagonist: Cimetidine, Ranitidine > Barbiturate- i nduced coma or sedation </li></ul>MEDICATIONS
  14. 19. <ul><li>Maintain fluid restriction. </li></ul><ul><li>Administer I.V. fluid as prescribed. </li></ul><ul><li>Administer Oxygen as prescribed. </li></ul><ul><li>Suction only as needed. </li></ul><ul><li>Assist with turning, coughing and deep breath. </li></ul><ul><li>Turn the patient every 2 hours. </li></ul><ul><li>Administer meds as prescribed. </li></ul><ul><li>Maintain a quiet environment. </li></ul>NURSING INTERVENTIONS
  15. 20. COMPLICATIONS <ul><li>Brainstem herniation </li></ul><ul><li>Diabetes InsipiduS </li></ul><ul><li>SIADH </li></ul><ul><li>Coma </li></ul><ul><li>Death </li></ul>

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