NURS 3664 Lecture Notes - Lecture 23: Cerebral Venous Sinus Thrombosis, Cerebrospinal Fluid, Blood Pressure
Document Summary
Skull has 3 essential components: brain tissue, blood, cerebrospinal fluid (csf) Intra abdominal and intrathoracic pressure (vomiting, bearing down) If one component increases, another must decrease to maintain icp. If volume increase continues, icp rises decompensation. Less than 50 is associated with ischemia and neuronal death. Critical to maintain map when icp is elevated. Failing compensation, clinical manifestations of increased icp (cushing"s triad) Sign of increased icp neurologic emergency. Systolic hypertension, widening pulse pressure above 180 mmhg. Nerve changes to optic and occular nerves. Icp and brain tissue oxygenation measurement (licox catheter) Glasgow coma scale of less than 8. Can control icp by removing csf (with ventricular catheter) Careful monitoring of volume of csf drained is essential. Adequate oxygenation abg"s guide oxygen therapy. Moves water out of cells and into blood. Monitor fluid intake, serum sodium and glucose levels. Concurrent antacids, h2 receptor blockers, proton pump inhibitors. Hypermetabolic and hypercatabolic state need for glucose.
