NUR%20214%20Alterations%20in%20Neurological%20Function%20Lecture%20#3%20Fall%202010

NUR%20214%20Alterations%20in%20Neurological%20Function%20Lecture%20#3%20Fall%202010

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NUR 214 NUR 214 DISORDERS OF INCREASED  INTRACRANIAL PRESSURE
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Cerebral Hemodynamics Cerebral Hemodynamics Cerebral Blood Flow Maintained at a rate that matches metabolic  needs of the brain 20% of cardiac output Cerebral Perfusion Pressure Pressure required to perfuse Brain Cells Cerebral Blood Volume Amount of blood in the intracranial vault  Cerebral Oxygenation Oxygen saturation in the internal jugular vein
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Intracranial Pressure (ICP) Intracranial Pressure (ICP) Normally 5-15mmHg Cerebral Autoregulation Compensatory alteration in the diameter  of the cerebral blood vessels Designed to maintain a constant blood  flow to the brain during changes in  cerebral perfusion pressure 
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Increased Intracranial Pressure Increased Intracranial Pressure Results from increased intracranial content Tumor Blood Edema Excess CSF To compensate for pressure changes alteration  of other cranial content occurs Displacement of Cerebral Spinal Fluid Cerebral Blood Volume changes
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Neurological Assessment  Neurological Assessment  Monitoring the ICP Monitoring the ICP Level of Consciousness Most Critical Piece of data Objective Documentation Glasgow Coma Scale Developed in 1974 to decrease ambiguity that  surrounds altered states of consciousness Measures degree of orientation Level of Alertness Ability to Problem Solve Ability to Follow Directions
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Glasgow Coma Scale Glasgow Coma Scale
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Intracranial Hypertension  Intracranial Hypertension  Stages of Compensation Stages of Compensation Stage 1 Effective compensation with vasoconstriction  and external compression of venous system May have no change in ICP Patient may be asymptomatic Stage 2 Continued expansion of intracranial contents  begin to tax compensatory mechanisms Subtle changes in clinical symptoms Confusion, restlessness, drowsiness Slight pupil changes  Surgical or medical intervention should be  initiated
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Intracranial Hypertension  Intracranial Hypertension  Beginning Decompensation Beginning Decompensation Stage 3 ICP begins to approach arterial pressure Brain tissues experience hypoxia and  hypercapnea Patient condition begins to rapidly deteriorate Decreased LOC Neurogenic Hyperventilation Cushing’sTriad Pupils become small and sluggishly reactive Surgical or Medical Intervention is essential
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Intracranial Hypertension 
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  • Spring '08
  • Criswell
  • intracranial hypertension, Hypertension  Intracranial Hypertension, Intracranial Hypertension  Intracranial, Intracranial Hypertension  Decompensation

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