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Terms in this set (23)
Parts of the cerebrum
frontal lobe, parietal lobe, occipital lobe, temporal lobe
Frontal Lobe function
speech, thought, learning, emotion, voluntary movement
Parietal Lobe function
processes sensory information
Occipital Lobe function
processes visual information
Temporal Lobe function
stores memory, interprets auditory stimuli
- controls muscle movement, balance
- coordinates stimuli from cerebral cortex, spinal cord
- grooves on surface allow more neuros to increase signal-processing capabilities
Brain Stem and its function
- contains midbrain, pons, medulla oblongata
- controls reflexes
- influences breathing, BP, HR
- connects sensory and motor pathways
- contains reticular formation
- relays information to cerebral cortex about alertness, arousal mechanisms
- directs brain's attention to sensory events
Spinal Cord function
transmits impulses to and from the brain
- ventral roots carry motor nerve fibers
- dorsal roots carry sensory nerve fibers
Normal Adult ICP
Increased ICP values
Sustained elevated pressure
What ICP value needs IMMEDIATE intervention?
Glascow Coma Scale evaluates what 3 responses?
E - Eye opening response
V - Verbal responses
M - Motor responses
Eye Opening response on GCS
4 = Spontaneous
3 = To voice
2 = To pain
1 = None
Verbal response on GCS
5 = Normal conversation
4 = Disoriented conversation
3 = Words, but not coherent
2 = No words, only sounds
1 = None
Motor responses on GCS
6 = Normal
5 = Localizes to pain
4 = Withdraws to pain
3 = Decorticate posture
2 - Decerebrate posture
1 = None
Lowest/Highest score on GCS
3 = Least Responsive/Lowest Score
15 = Most Responsive/Highest Score
GCS < 8
Severe neuro deterioration/brain injury
GCS < 3
Unresponsive; brain death; not compatible with life
- Abnormal posturing indicated by rigidity, flexion of the arms to the chest, clenched fists, extended legs.
- Indicative of damage to the corticospinal tract
Remember - "cor" = "core" arms towards the center of the chest
- Abnormal body posturing indicated by rigid extension of the arms and legs, downward pointing of the toes, and backward arching of the head.
- Indicative of deterioration of the brainstem
Remember - all the "E" letters in the word decerebrate and relate it to the word Extension
Criteria for Brain Death
- Unresponsive coma with absent motor and reflex movements.
- No spontaneous respirations (apnea).
- Pupils fixed (unresponsive to light) and dilated.
- Absent ocular responses to head turning and caloric stimulation.
- Flat electroencephalogram (EEG) and no cerebral blood circulation present on angiography (if performed).
- Persistence of these manifestations for 30 minutes to 1 hour and for 6 hours after onset of coma and apnea.
Medications used in the management of increased intracranial pressure include:
- Diuretics, particularly osmotic diuretics; sometimes loop diuretics are also used.
- Antipyretics for fever.
- Medications to induce sedation and paralysis as chemical restraints.
- Antiseizure drugs.
- Drugs for gastrointestinal prophylaxis such as histamine H2- receptors or proton pump inhibitors.
Independent actions by the nurse for a patient with increased ICP
- Measuring vital signs.
- Assessing level of consciousness (LOC), pupil response, and neurologic status.
- Monitoring fluid intake and output.
- Reducing environmental stimuli.
- Raising the head of the bed 30 degrees to decrease ICP (if appropriate and there are no contraindications).
- Taking precautions for seizures, including padding side rails.
- Monitoring cerebral perfusion pressure (CCP)/ICP as indicated.
- Implementing deep vein thrombosis prophylaxis, such as graduated compression stockings or sequential compression devices.
= Administering IV fluids as ordered.
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