Flashcards in Test 3 Deck (22)
How is CSF produced?
Through the blood...when it has circulated through the ventricular system of the brain, it is reabsorbed back into the vasculature
What is the significance of the Circle of Willis?
It provides different pathways for blood to circulate if there is a blockage in a certain vessel (GOOD). It also is known to commonly accrue aneurysms (BAD).
Which category of the GCS is most indicative of the patient's eventual outcome?
What are the most commonly used scans for possible brain/spinal cord injuries?
What indicates infection in a lumbar puncture in in CSF?
Low glucose in the CSF indicates what kind of infection?
High protein in the CSF indicates what kind of infection?
Pink CSF is an indication of what?
Cranial nerves (example: optical nerve) are sympathetic or parasympathetic and central or peripheral?
Parasympathetic cause the pupils to?
What does global brain ischemia cause the pupils to do?
Parasympathetic and peripheral
Fixed and dilated
Explain the oculocephalic reflex and the oculovestibular reflex.
Oculocephalic reflex or "dolls eyes" is standing at the head of the bed, turn head to side to side. If the eyes don't move there is no brain activity. (Eyes should track back or shift)
Oculovestibular reflex is cold water into the ear and the eyes will move to look at the ear you are shooting water into. (no movement is brain dead)
How do you calculate cerebral perfusion pressure? (CPP). And what are the normals
MAP (90-100)-ICP (0-15)= CPP (60-80)
What does Cushing's Triad represent?
-↑ systolic BP, diastolic normal/↓ (widened pulse pressure)
-↓ HR (starts tachy, then goes down)
What is the difference between primary and secondary head injuries?
Primary (ie. getting hit in the head with baseball bat)
Secondary (ie. aftermath of wrong treatment of initial head injury)
Are epidural bleeds arterial or venous? Subdural?
What is a classic distinction of epidural hematoma?
"Lucid interval"- they go down, are coherent, then go down again, deadsies
How do subdural hematomas present?
Often undetectable on CT then kills you 2-3 days later if not treated
What are indications for ICP monitoring?
-S&S of ↑ ICP
-Less severe brain injury which requires deep sedation
Nursing management for increased ICP:
-Keep c-spine and head straight
What are complications of an aneurysm? (9)
What is the cardinal sign of increased ICP?
Change in LOC
A patient displays with a head injury, is hypotensive and tachycardic. What does this indicate?
The pt. likely has an injury elsewhere (ie. internal bleeding, etc.)
Head injuries usually present with hypertension and bradycardia.
What are classic signs of a basilar skull fracture?
Leakage of CSF out the nose or ears, raccoon eyes, battle signs.
Nursing management for neuro patients:
O2, physical assessment, elevate HOB, check c-spine, ID band for szr precaution, neuro checks, SCD, v/s
What is a ventriculostomy and where is it placed?
Used to drain CSF and is placed on non-dominant side of the brain.