L3 Flashcards
(17 cards)
Autoregulation of cerebral blood flow functions well when
Mean arterial pressure (MAP) is within 70 to 150 mmHg
MAP below 70 mmHg
Cerebral blood flow decreases, and there is symptoms of cerebral ischemia, such as syncope and blurred vision
MAP above 150 mmHg
Vessels are maximally constricted and further vasoconstrictor response is lost
Cerebral perfusion pressure (CPP) calculation
= Mean arterial pressure (MAP) - Intracranial Pressure (ICP)
* MAP = (SBP+2DBP)/3
Cerebral perfusion pressure (CPP) < 50 mmHg
Associated with ischemia and neuronal death
Cerebral perfusion pressure (CPP) < 30 mmHg
Resulted in ischemia and death
Cushing’s triad
Systolic hypertension with bradycardia
Complications caused by increased intracranial pressure
Brain herniation;
Compression of the brainstem (caused respiratory arrest);
Brain death when cerebral blood flow stops
Unilateral fixed dilated pupil
Pressure on cranial nerve III
Bilateral fixed dilated pupils
Brain herniation
Pinpoint pupils
Brainstem haemorrhage
Small, equal, reactive pupils
Bilateral diencephalic damage affecting sympathetic innervation originating from the hypothalamus
Nonreactive, midpositioned pupil
Midbrain damage
Femoral artery site care
1) Apply pressure to the femoral artery
2) Keep bed rest for 6 hours for stable blood clot formation
3) Check groin area for bleeding and hematoma
4) Monitor dorsal pedal and posterior tibial of the affected limb Q1H
5) Monitor temperature, colour pain and paresthesia to check early evidence of acute arterial occulsion (blockage of blood vessel)
Treatment for aneurysm
- Endovascular coiling
- Surgical clipping
Monitor neurological status
- Q1-2H in the first 24 hours
- GCS
Maintain bladder and bowel function
- bladder exercise Q2H
- encourage fluid intake to prevent urinary tract infection and constipation
- monitor I&O
