Stroke
What is Cushing's Triad
Widening pulse pressure, bradycardia, irregular respirations
Invasive procedure to drain cerebrospinal fluid (CSF) and monitor intracranial pressure (ICP).
Ventriculostomy
The mildest form, characterized by a small gap in the spine without an opening or sac. Often asymptomatic and detected incidentally.
Spina Bifida Oculta
What is the first sign of PD and when is it most visable
Tremors and they are best seen at rest
How to calculate CPP and what is the normal range
MAP-ICP= CPP
Normal range is above 70
What is the window from onset of symptoms to getting TPA
3-4.5 hours
What is Mannitol used for and how does it work?
Lowers ICP by diuresis contraindicated with dehydration
A more severe form with a visible sac protruding from the spine. It includes two subtypes: Meningocele and Myelomeningocele.
Spina bifida cysica
How does Levodopa-Carbidopa work, what is its contraindication?
Increases dopamine and reduces symptoms
narrow angle glaucoma
What is the norma ICP range
5-15 anything over 20 requires immediate attention
Right-sided strokes result in what?
Left-sided weakness, Spatial/perceptual deficits, tendency to minimize problems, short attention spans, impulsive, impaired judgement
How do fevers effect ICP
Increase ICP
The sac contains meninges and cerebrospinal fluid but no spinal cord involvement. Less severe than myelomeningocele.
Meningocele
Medication treatment for SCI
High dose of glucocorticoids, vasopressors/fluids, PPI, IVF
What is Vasogenic cerebral edema?
Results from disruption of blood brain barrier, fluid leaks from intravascular space to extravascular space, exposing brain cells to toxic products from the blood
Left-sided stroke results in what?
Right-sided weakness, impaired speech/aphasia, slow performance, aware of deficits, impaired comprehension related to language and math
What are nursing interventions to lower ICP
Keep HOB 30 degrees
Keep head midline
Avoid hip flexion
Minimize stimili
Limit suctioning to 10 seconds
Monitor I&O's
The most severe form, where the sac contains spinal cord, meninges, and nerves, leading to significant neurological impairment, including paralysis and loss of function below the defect.
Myelomeningocele
s/s of PD
Tremors, blank facial expressions, slow monotone voice, short shuffling gait, and forward tilt posture
What is cytotoxic cerebral edema?
Disruption of cell membrane integrity results in cerebral hypoxia and SIADH secretions
Modifiable risk factors for strokes
Smoking, obesity, HTN, DM, heart disease, drugs, alcohol, metabolic syndrome, lack of excersise.
What are the early signs of Increased ICP
Agitation, confusion, AMS, restlessness
If your pt is awake and able to speak to you and follow commands what is there GCS
15
A spinal cord injury to C1-C3 result in what?
Ventilator dependency
What is interstitial cerebral edema?
Usually a result of hydrocephalus, excess CSF production, obstruction of flow, or inability to reabsorb of CSF, treated with a shunt