SCRN EXAM 2022 QUESTIONS AND ANSWERS 2024

cerebral cortex - gray matter on the outermost section of the cerebrum and cerebellum composed of neuronal cell bodies Four lobes of the cerebral cortex and cerebrum - Frontal Parietal Temporal Occipital Oxygen supplemental need - > 93% BP goal post tPA - <180/105 Vast majority of fatal hemorrhages occur within - the first 12 hours hyperthermia management - strict < 38.0 or 100.4 tylenol for fevers neurogenic fevers with an early increase in temperature after 24 hours - can restart antihypertensives blood pressure goals if they did not receive tPA - systolic < 220 diastolic < 120 ** do not want to bring BP down fast d/t risk for hypotension Co2 is a potent vasodilator - leads to an increase in ICP more blood volume to brain mild hyperventilation for low CO2 leads to lower ICP and vasoconstriction Hypocarbia in extreme can lower cerebral blood flow by too much door to physician - < 10 min door to team - < 15 min door to CT - < 25 min Door to interpretation - < 45 min door to tPA - < 60 min BP if they did not receive TPA - 220/120 Acute care management - continue to monitor neurological status begin early mobilization of patient close observation during transition sitting to standing intracranial hemorrhage - hypertensive bleed venous thrombosis trauma subarachnoid hemorrhage - trauma aneurysmal non-aneurysmal venous thrombosis ischemic stroke - large vessel occlusions (LVO) usually from embolic sources ICA MCA ACA PCA PICA AICA Basilar Small vessel occlusions - generally from atherosclerosis vessels that feed cerebrum - MCA