NSG 340 FINAL EXAM questions with
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answers
causes of increased ICP - CORRECT ANSWERS ✔✔Hypotension
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Hypoxemia (low oxygen - vasodilation) |\ |\ |\ |\
Hypercapnia (causes vasodilation) (can be fixed by increasing |\ |\ |\ |\ |\ |\ |\ |\
respirations on the ventilator) |\ |\ |\
swelling (FVE, trauma, stoke)
|\ |\ |\
bleeding (stroke, injury) |\ |\
increases pressure = pushes on brain stem = breathing and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
heart beat alterations
|\ |\
Pathophysiology of increased ICP - CORRECT ANSWERS |\ |\ |\ |\ |\ |\ |\
✔✔intracranial hypertension leads to ICP > 20 |\ |\ |\ |\ |\ |\ |\
pressure pushes on brainstem causing s/s such as:
|\ |\ |\ |\ |\ |\ |\
decreased LOC (usually first sign) |\ |\ |\ |\
cushings triad - bradypnea, bradycardia, hypertension
|\ |\ |\ |\ |\ |\
slow/sluggish pupillary reaction |\ |\
h/a (worst headache I have ever had)
|\ |\ |\ |\ |\ |\
n/v (sometimes projectile)
|\ |\
restless & dizzy |\ |\
decerebrate and decorticate posturing = signifies abnormal |\ |\ |\ |\ |\ |\ |\
motor fx |\
,NSG management of increased ICP - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔reposition - HOB at 30-45 |\ |\ |\ |\
maintain normothermia |\
decrease stimuli |\
ventilate |\
MEDS:
mannitol - diuretic (remove fluid)
|\ |\ |\ |\
anticonvulsant / sedation / paralytic agent |\ |\ |\ |\ |\
analgesic / anti-pyretic - regulate temp & 02 demand
|\ |\ |\ |\ |\ |\ |\ |\
vaso agent to control BP & CPP of > 70
|\ |\ |\ |\ |\ |\ |\ |\ |\
steroid = decrease inflammation of the brain
|\ |\ |\ |\ |\ |\
abx - if info
|\ |\ |\
anti emetic
|\ |\
meperidine - decrease shivers that increase O2 demand
|\ |\ |\ |\ |\ |\ |\
complications of increased ICP - CORRECT ANSWERS ✔✔infection |\ |\ |\ |\ |\ |\ |\
corneal abrasions |\
falls
seizures
Patient and family education for increased ICP - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔educate about precipitating event, craniotomy,
|\ |\ |\ |\ |\ |\
expected outcomes |\
critical care management postoperatively
|\ |\ |\
, (later) educated on medications, incisional care, safety, s/s of infx
|\ |\ |\ |\ |\ |\ |\ |\ |\
& increased ICP
|\ |\ |\
(if near deficits present) encourage family to get involved in care
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and learn rehab |\ |\
support group for both parties |\ |\ |\ |\
hemorrhagic stroke - CORRECT ANSWERS ✔✔results from: |\ |\ |\ |\ |\ |\
- ruptured or leaking aneurysm
|\ |\ |\ |\
- arteriovenous malformation
|\ |\
- trauma
|\
- arterial rupture
|\ |\
- HTN|\
surgery to remove hematoma / relieve ICP |\ |\ |\ |\ |\ |\
ischemic stroke - CORRECT ANSWERS ✔✔TIAs often occurs prior
|\ |\ |\ |\ |\ |\ |\ |\
partial / complete |\ |\
increased ICP |\
treat with tPA within 3 hours
|\ |\ |\ |\ |\
or carotid endarterectomy (removal of material from inside
|\ |\ |\ |\ |\ |\ |\ |\
carotid artery if cause of stroke) |\ |\ |\ |\ |\
s/s of stroke - CORRECT ANSWERS ✔✔acute/sudden onset
|\ |\ |\ |\ |\ |\ |\
|\ |\ |\ |\ |\ |\
answers
causes of increased ICP - CORRECT ANSWERS ✔✔Hypotension
|\ |\ |\ |\ |\ |\ |\
Hypoxemia (low oxygen - vasodilation) |\ |\ |\ |\
Hypercapnia (causes vasodilation) (can be fixed by increasing |\ |\ |\ |\ |\ |\ |\ |\
respirations on the ventilator) |\ |\ |\
swelling (FVE, trauma, stoke)
|\ |\ |\
bleeding (stroke, injury) |\ |\
increases pressure = pushes on brain stem = breathing and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
heart beat alterations
|\ |\
Pathophysiology of increased ICP - CORRECT ANSWERS |\ |\ |\ |\ |\ |\ |\
✔✔intracranial hypertension leads to ICP > 20 |\ |\ |\ |\ |\ |\ |\
pressure pushes on brainstem causing s/s such as:
|\ |\ |\ |\ |\ |\ |\
decreased LOC (usually first sign) |\ |\ |\ |\
cushings triad - bradypnea, bradycardia, hypertension
|\ |\ |\ |\ |\ |\
slow/sluggish pupillary reaction |\ |\
h/a (worst headache I have ever had)
|\ |\ |\ |\ |\ |\
n/v (sometimes projectile)
|\ |\
restless & dizzy |\ |\
decerebrate and decorticate posturing = signifies abnormal |\ |\ |\ |\ |\ |\ |\
motor fx |\
,NSG management of increased ICP - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔reposition - HOB at 30-45 |\ |\ |\ |\
maintain normothermia |\
decrease stimuli |\
ventilate |\
MEDS:
mannitol - diuretic (remove fluid)
|\ |\ |\ |\
anticonvulsant / sedation / paralytic agent |\ |\ |\ |\ |\
analgesic / anti-pyretic - regulate temp & 02 demand
|\ |\ |\ |\ |\ |\ |\ |\
vaso agent to control BP & CPP of > 70
|\ |\ |\ |\ |\ |\ |\ |\ |\
steroid = decrease inflammation of the brain
|\ |\ |\ |\ |\ |\
abx - if info
|\ |\ |\
anti emetic
|\ |\
meperidine - decrease shivers that increase O2 demand
|\ |\ |\ |\ |\ |\ |\
complications of increased ICP - CORRECT ANSWERS ✔✔infection |\ |\ |\ |\ |\ |\ |\
corneal abrasions |\
falls
seizures
Patient and family education for increased ICP - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔educate about precipitating event, craniotomy,
|\ |\ |\ |\ |\ |\
expected outcomes |\
critical care management postoperatively
|\ |\ |\
, (later) educated on medications, incisional care, safety, s/s of infx
|\ |\ |\ |\ |\ |\ |\ |\ |\
& increased ICP
|\ |\ |\
(if near deficits present) encourage family to get involved in care
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
and learn rehab |\ |\
support group for both parties |\ |\ |\ |\
hemorrhagic stroke - CORRECT ANSWERS ✔✔results from: |\ |\ |\ |\ |\ |\
- ruptured or leaking aneurysm
|\ |\ |\ |\
- arteriovenous malformation
|\ |\
- trauma
|\
- arterial rupture
|\ |\
- HTN|\
surgery to remove hematoma / relieve ICP |\ |\ |\ |\ |\ |\
ischemic stroke - CORRECT ANSWERS ✔✔TIAs often occurs prior
|\ |\ |\ |\ |\ |\ |\ |\
partial / complete |\ |\
increased ICP |\
treat with tPA within 3 hours
|\ |\ |\ |\ |\
or carotid endarterectomy (removal of material from inside
|\ |\ |\ |\ |\ |\ |\ |\
carotid artery if cause of stroke) |\ |\ |\ |\ |\
s/s of stroke - CORRECT ANSWERS ✔✔acute/sudden onset
|\ |\ |\ |\ |\ |\ |\
