Intracranial Pressure
Syndrome of Inappropriate ADH
Diabetes Insipidus
Autonomic Dysreflexia
Medications
100

the earliest symptom reported by a client with increasing ICP

what is headache

100

signs and symptoms specific to later stages of SIADH

what is weight gain, confusion, personality changes, extreme muscle weakness and hyponatremia

*early s/s include weakness and muscle cramps*

100

signs and symptoms associated with DI

what is polyuria, polydipsia and hypernatremia

dehydration

100

signs and symptoms associated with AD

what is severe hypertension, bradycardia and pounding headache.

*pale/cool skin below area of injury and diaphoresis/flushed skin above the level of injury

*"severe HTN"- over 150mmHg or 20-40mmHg above the client's normal*

100

a medication used to prevent seizures in a client who has a history of a TBI

what is Phenytoin

200

the earliest sign of a client with increasing ICP

what is decreased LOC

200

causes of SIADH

what is pressure on the pituitary gland, tumors

*pressure increases ADH release*
*tumors can produce, secrete or stimulate an ADH-like substance*

200

causes of DI

what is pressure on the pituitary causing a decrease of ADH, a complication of pituitary surgery (Sublabial Transsphenoidal)

*stroke, trauma, surgery, idiopathic*

200

causes of AD

what is noxious stimuli- most often bladder, but can also be bowels, pressure injury/pressure on skin.
could also be extreme temperatures, trauma or sexual activity

*bladder, bowels and breakdown- 3Bs*

200

a medication administered to a client with a TBI and the nurse reports 9L urine output over the past 24-hours

what is desmopressin (DDAVP)

*often administered as nasal spray and is first line treatment*

300

What is the primary pathophysiological mechanism behind increased intracranial pressure?  

What is an increase in the volume of brain tissue, blood, or cerebrospinal fluid within the skull, leading to elevated pressure

*CSF (10%), brain (80%) and blood (10%).

icp- *what is <15 mmHg
*prolonged and over 20 is not good!*

300

nursing interventions for a client with SIADH

what is fluid restrictions, increase sodium intake

*administer meds as prescribed, monitor Na, treat underlying cause- chemo or XRT (radiation treatment)* 

300

the difference between central and nephrogenic DI

what is decreased ADH production (central) vs unresponsive kidneys in presence of adequate ADH (nephrogenic)

300

nursing interventions to prevent AD

what is:
- straight catheterization Q4-6H/ check indwelling for kinks
- maintaining wrinkle free linens and clothes
- T&P Q2H
- maintain a regular bowel routine

300

the specific assessment that may prompt the nurse to administer Hydralazine over Labetalol for a stroke client who is hypertensive. 

what is heart rate 

*"lol" are beta blockers, if HR is low choose the hydralazine*

400

widening pulse pressure (increasing BP), decreasing HR and decreasing RR, also often involves increased temperature

what is Cushing's Triad
*normal pulse pressure is 40-60 mmHg*
*may see Cheyne stokes- rhythmic, periods of apnea*

400

Regular monitoring of this blood component is crucial in managing SIADH to avoid rapid changes that can be dangerous.

what is sodium

400

nursing interventions for a client with DI

what is administration of desmopressin, hypotonic NS can replace fluids (0.45% NS), monitor neuro and CVS, monitor electrolytes (Na, K, Ca), maintain adequate fluid intake, avoid diuretics/foods that cause such, 

400

first intervention for a client with a T4 spinal cord injury who reports a sudden headache and has excessive hypertension 

what is to elevate the HOB to high fowlers

*prevent hypertensive stroke*
*next- loosen tight clothing and check for noxious stimuli to eliminate it*

400

a hypertonic intravenous fluid administered to treat increased ICP

what is 3% NS

*if Na is <120mmol/L*

500

What advice should be given to a patient to help manage increased intracranial pressure at home?

What is to avoid activities that increase intracranial pressure, such as straining during bowel movements or heavy lifting

500

These medications, such as conivaptan and tolvaptan, are used to block the action of antidiuretic hormone in SIADH patients.

What are vasopressin receptor antagonists.

*so it blocks the receptor so the kidneys will not reabsorb water.
Diuretic such as Furosemide can work as well.*


500

What is a severe complication that can arise from untreated Diabetes Insipidus

What is severe dehydration leading to hypovolemic shock. 

*early signs- restless, decreased BP, increased HR*
*later- increased depth of respirations*

500

What is an important piece of advice you would give to a patient with a spinal cord injury to prevent Autonomic Dysreflexia?  

What is to regularly empty the bladder and bowel, and to check for any skin irritations or pressure sores.

500

Which medication is commonly used to reduce intracranial pressure by drawing fluid out of the brain?  

 What is mannitol

*osmotic diuretic*

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