,
,Clinical manifestations that require immediate intervention for acute SDH? - ANSWER-- Coma,
increase BP, decreased HR, slow RR
What emergency procedure would be preformed for a patient with a epidural hematoma? -
ANSWER-Burr holes - release blood accumulated in the between the skull and dura bc it can
cause neurological deficits and respiratory arrest
Early s/s of increased ICP - ANSWER-- change in LOC - earliest
- disorientation, restlessness, increased respiratory effort (Kussmals), purposeless movements,
mental confusion,
- pupillary changes and impaired extraocular movements
-
late s/s of increased ICP (vital sign changes) - ANSWER-- Cushing's Triad
- bradycardia, bradypnea, widen pulse pressure (increased systolic, decreased diastolic_
- increased BP and temp
Late signs of increased ICP - ANSWER-- patient becomes erratic
- GCS score <8
- LOC continues to deteriorate
- Chain-stokes (rhythmic waxing and waning of ate and depth with brief episodes of apnea
- Ataxic breathing - irregular breathing with random deep and shallow breath
- projectile vomiting
- hemiplegia
- decorticate
- decerebrate
- flaccidity before death
, - loss of brain stem reflexes: pupillary, corneal, gag, and swallowing reflexes are not present
(signs of approaching death)
Normal ICP pressure - ANSWER-5-15 mmHg
Normal CPP - ANSWER-70-100 mmHg
an ICP >25 indicates? - ANSWER-worsening if pressure does not return within 5 minutes
a CPP <50mmHg indicates - ANSWER-No blood glow and irreversible damage
What is the goal for a Craniotomy post op? - ANSWER-- aimed at detecting and reducing cerebral
edema, relieve ing pain, preventing seizures, monitoring ICP, and neurological status
Plan of care post op for a craniotomy? - ANSWER-- reduce cerebral edema by giving: mannitol, IV
dexamethasone, and taper off when discontinuing
- relieve pain and decrease temp with:
- acetaminophen (mild)
- codeine and morphine - for intense pain
- prophylactic anticonvulsants: phenytoin and levetiracetam
- remove the ICP monitor as soon as ICP is regulated and is stable
what would require immediate intervention for a patient with head trauma? - ANSWER-- CSF
drainage: meningitis infection can occur
- A depressed fracture - require surgery within 24 hrs
- A battle sign (bruising over the mastoid bone)
- Pts who pees ALOT - indicate dilute urine --> DI
- GCS - score <8
- Decorticate and Decerebrate posturing
,Clinical manifestations that require immediate intervention for acute SDH? - ANSWER-- Coma,
increase BP, decreased HR, slow RR
What emergency procedure would be preformed for a patient with a epidural hematoma? -
ANSWER-Burr holes - release blood accumulated in the between the skull and dura bc it can
cause neurological deficits and respiratory arrest
Early s/s of increased ICP - ANSWER-- change in LOC - earliest
- disorientation, restlessness, increased respiratory effort (Kussmals), purposeless movements,
mental confusion,
- pupillary changes and impaired extraocular movements
-
late s/s of increased ICP (vital sign changes) - ANSWER-- Cushing's Triad
- bradycardia, bradypnea, widen pulse pressure (increased systolic, decreased diastolic_
- increased BP and temp
Late signs of increased ICP - ANSWER-- patient becomes erratic
- GCS score <8
- LOC continues to deteriorate
- Chain-stokes (rhythmic waxing and waning of ate and depth with brief episodes of apnea
- Ataxic breathing - irregular breathing with random deep and shallow breath
- projectile vomiting
- hemiplegia
- decorticate
- decerebrate
- flaccidity before death
, - loss of brain stem reflexes: pupillary, corneal, gag, and swallowing reflexes are not present
(signs of approaching death)
Normal ICP pressure - ANSWER-5-15 mmHg
Normal CPP - ANSWER-70-100 mmHg
an ICP >25 indicates? - ANSWER-worsening if pressure does not return within 5 minutes
a CPP <50mmHg indicates - ANSWER-No blood glow and irreversible damage
What is the goal for a Craniotomy post op? - ANSWER-- aimed at detecting and reducing cerebral
edema, relieve ing pain, preventing seizures, monitoring ICP, and neurological status
Plan of care post op for a craniotomy? - ANSWER-- reduce cerebral edema by giving: mannitol, IV
dexamethasone, and taper off when discontinuing
- relieve pain and decrease temp with:
- acetaminophen (mild)
- codeine and morphine - for intense pain
- prophylactic anticonvulsants: phenytoin and levetiracetam
- remove the ICP monitor as soon as ICP is regulated and is stable
what would require immediate intervention for a patient with head trauma? - ANSWER-- CSF
drainage: meningitis infection can occur
- A depressed fracture - require surgery within 24 hrs
- A battle sign (bruising over the mastoid bone)
- Pts who pees ALOT - indicate dilute urine --> DI
- GCS - score <8
- Decorticate and Decerebrate posturing
