part 2 Flashcards
1
Q
What makes up the Glasgow Coma Scale?
A
eye
verbal
motor response
2
Q
According to the GCS what is the score that is generally accepted at coma?
A
- normal is 15
- coma is 8 and less
3
Q
The brain is well protected but also vulnerable to what?
A
pressure that may accumulate within the cranium
4
Q
As ICP increases, signs and symptoms become more pronounced and what deteriorates?
A
LOC
5
Q
What are the assessment parameters for increased ICP?
A
- LOC
- Pupillary reaction
- Vital signs
- Frequency of assessment: depends on condition; ranges from q15min to q2hours
6
Q
What are the clinical manifestations of increased ICP in infants?
A
- irritability, poor feeding
- high pitched cry, difficult to soothe
- fontanels: tense, budging
- cranial sutures separated
- eyes: setting-sun sign
- scalp veins: distended
7
Q
What are the clinical manifestations of increased ICP in children?
A
- headche
- forceful vomiting
- seizures
- drowsiness, lethargy
- diminished physical activity
- inability to follow simple commands
8
Q
What are the late signs of increased ICP?
A
- bradycardia
- decreased motor response to command
- decreased sensory response to painful stimuli
- alterations in pupil size and reactivity
- extension or flexion posturing
- decreased consciousness
- coma
9
Q
What are the specific special diagnostic procedures for ICP?
A
- lab tests
- EEC (electroencephalography)
- lumbar puncture
- assessment of evoked potentials (auditory and visual)
- imaging (CT, MRI, Radiography)
10
Q
Explain the respiratory management in the comatose child.
A
- airway management is primary concern
- cerebral hypoxia lasting >4 minutes may cause irreversible brain damage
- CO2 retention causes vasodilation, increased cerebral blood flow, and increased ICP
- gag and cough reflexes may be minimal
- risk of aspiration of secretions is increased
