ICP MONITORING
Normal ICP
What is 10 - 15 mmHg?
FAST
What is face drooping, arm drifting, slurred speech, and time?
What is abnormal flexion of the arms to the core of the body?
Three components of the GCS
What is the best verbal response, best motor response, and best eye opening response?
Normal CPP
What is 80 to 100?
Reasons for ICP monitoring
What is post cardiac arrest, stroke, trauma, TBI, brain tumor, systemic infarction, hydrocephalus, craniotomy, coma, and subarachnoid hemorrhage?
Epidural bleed
What is an arterial bleed, "wake up and die", rapidly evolving?
Normal oculocephalic reflex in coma patients
What is turning the head and the eyes move in the same direction?
Components of a neuro exam
What is GCS, vital signs, sensory function, reflexes, brainstem function, pupillary response, and motor function?
What is 30 degrees?
Nursing care for ICP monitoring
What is keep HOB at 30 degrees, sedation and analgesia, temperature control, zero the transducer at the level of the tragus of the ear, and keep system above the brain?
Indications for thrombolytic therapy
What is greater than 18 years of age and onset of stroke symptoms less than 4.5 hours?
Normal oculovestibular reflex
What is cold water being placed in the ear and turning the head the same way?
Cerebral perfusion pressure equation
What is CPP = MAP - ICP?
Reason why cluster care may not be used
What is the patient cannot tolerate cluster care?
Monroe-Kelly Hypothesis
What is one compartment is increased therefore one or both of the other compartments must decrease in order to comply?
Types of strokes
What is an ischemic stroke and a hemorrhagic stroke?
Brainstem reflexes
What is the corneal reflex, the gag/cough reflex, the oculocephalic reflex, and the oculovestibular reflex?
What is an osmotic diuretic used to decrease fluid in the brain?
Signs of autonomic dysreflexia
What is hypertension, cardiac dysrhythmias, profuse sweating, throbbing headache, and bradycardia?
Cushing's Triad
What is hypertension, bradycardia, and irregular respirations?
Contraindications for thrombolytic therapy
What is recent trauma, recent stroke, uncontrolled HTN at time of treatment, aneurysm,AV-malformation, neoplasm, uncontrolled seizures during time of symptoms, and intracerebral hemorrhage?
How to test for water function
What is applying nail bed pressure and seeing how the patient responds?
DI and SIADH signs
SIADH: what is low sodium, low urine output, and high ADH?
Nursing care for autonomic dysreflexia
What is monitoring BP every 3-5 minutes, placing the patient on a cardiac monitor, loosening restrictive clothing or devices, checking the bladder and bowel, sitting the patient upright and lowering their legs, and giving short acting antihypertensive medications?