Altered LOC
Intracranial Pressure (ICP)
Seizures
Traumatic Brain Injury (TBI)
Intracranial Aneurysms & Brain Tumors
100
These labs are checked to determine possible causes of altered LOC.

What are electrolytes, blood glucose, serum osmolality, ABGs, liver function, and toxicology? 

100

This condition is characterized by dilation of the ventricles which leads to increased ICP. It can be caused by abnormal production, circulation, or reabsorption of CSF. 

What is hydrocephalus? 

100

Seizures cause disruptions of these four functions. 

What are skeletal motor, sensation, autonomic, and LOC? 

100

This is typically the treatment for any focal brain injury. 

What is surgery? 

100

This is the top priority when taking care of a patient with an intracranial aneurysm to prevent rupture. 

What is preventing hypertension? 

200

Confusion, agitation, difficulty to arouse, and unresponsiveness are all indicators of this. 

What is declining level of consciousness? 

200

Increased ICP can lead to this potentially fatal complication that causes decreased cerebral perfusion due to compression of brain tissues.  

What is brain herniation? 

200

These are priorities when a patient is actively seizing. 

What are protect from injury, turn them on their side, and maintain airway? 

200

These focal brain injuries are characterized by severe headaches with rapid onset and require emergency surgery. The main difference is where the bleeding occurs. 

What are subdural hematoma and subarachnoid hemorrhage? 

200

If it is suspected that an aneurysm has ruptured, the first test done is a CT. If the CT is negative, a lumbar puncture may be done to look for this, which would confirm a subarachnoid hemorrhage (SAH). 

What is bloody CSF? 

300

This pathway of neurons is located in the brainstem and connects to the thalamus, cerebral cortex, and hypothalamus. It is responsible for regulating consciousness (sleep-wake cycle), attention and focus, filtering sensory input, and emotional responses. 

What is the reticular activating system (RAS)?

300

Cushing's triad consists of these symptoms that indicate late signs of increased ICP/impending herniation. 

What are hypertension, bradycardia, and irregular respirations (Cheyne-Stokes, ataxic)? 

300

This subtype of generalized seizures is an emergency because it can cause hypoxia and brain damage. It occurs when seizure activity lasts longer than five minutes without recovery of consciousness between episodes. 

What are status seizures? 

300

This diffuse brain injury is characterized by brief loss of consciousness and/or confusion with no structural damage.

What is a mild concussion? 

300

Manifestations of brain tumors that vary from other brain injuries/disorders.

What are headache that is worse in the morning and relieved by vomiting and vomiting without nausea? 

400

As cerebral or brainstem function deteriorates, LOC declines. These are other neurological changes that can also occur.

What are posturing (decorticate/decerebrate), absent/irregular respirations, fixed and dilated pupils, and flat EEG (brain death)? 

400

Care for a patient with increased ICP would include these to prevent further increases. 

What are minimal stimuli, HOB at 30 degrees, hyper or isotonic fluids, osmotic diuretics (Mannitol), antipyretics, antihypertensives, and anticonvulsants? 

400

This subtype of seizure is characterized by retaining awareness during the seizure activity. Symptoms may include jerking of a single extremity, tingling, Deja vu, lip-smacking, or staring spells. 

What are simple focal seizures? 

400

Basilar fractures occur when bones at the base of the skull are broken. These three symptoms commonly associated with this focal brain injury present as bruising around the eyes, bruising behind the ears, and drainage from the eyes or nose. 

What are raccoon eyes, Battle's sign, and CSF leakage? 

400

This class of drugs treat intracranial aneurysms by preventing vasospasm. 

What are calcium channel blockers? 

500

There are many causes of altered LOC, but the most common causes can be remembered with the acronyms AEIOU and TIPS. 

What are alcohol, epilepsy, insulin (hypoglycemia), opioids/oxygen, uremia, tumor/trauma, injury, psychosis, and stroke/sepsis?

500

A patient with increased ICP may have an external ventricular drain (EVD) to measure ICP and drain excess CSF. This drain must be kept at this level to ensure accurate measurement of ICP and proper CSF drainage. 

What is tragus?

500
Common triggers for seizures include stress, sleep deprivation, alcohol/drug withdrawal, infection, metabolic imbalances, and brain injuries. This is the most common cause of seizures in children.

What is fever?

500

These are the three mechanisms associated with TBIs. They are characterized by being struck by a moving object, coup and countercoup, and rotating in the skull. 

What are contact phenomena, acceleration-deceleration, and rotational?
500

When a brain tumor is a secondary malignancy, it is most commonly metastasized from this organ. 

What are the lungs? 

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