Intracranial pressure

1. Select the main structures below that play a role with altering intracranial pressure:

2. The Monro-Kellie hypothesis explains the compensatory relationship among the structures in the skull that play a role with intracranial pressure. Which of the following are NOT compensatory mechanisms performed by the body to decrease intracranial pressure naturally? Select all that apply:

3. A patient is being treated for increased intracranial pressure. Which activities below should the patient avoid performing?

4. A patient is experiencing hyperventilation and has a PaCO2 level of 52. The patient has an ICP of 20 mmHg. As the nurse you know that the PaCO2 level will?

5. You’re providing education to a group of nursing students about ICP. You explain that when cerebral perfusion pressure falls too low the brain is not properly perfused and brain tissue dies. A student asks, “What is a normal cerebral perfusion pressure level?” Your response is:

6. Which patient below is at MOST risk for increased intracranial pressure?

7. A patient with increased ICP has the following vital signs: blood pressure 99/60, HR 65, Temperature 101.6 ‘F, respirations 14, oxygen saturation of 95%. ICP reading is 21 mmHg. Based on these findings you would?

8. A patient has a ventriculostomy. Which finding would you immediately report to the doctor?

9. External ventricular drains monitor ICP and are inserted where?

10. Which of the following is contraindicated in a patient with increased ICP?

11. You’re collecting vital signs on a patient with ICP. The patient has a Glascoma Scale rating of 4. How will you assess the patient’s temperature?

12. A patient who experienced a cerebral hemorrhage is at risk for developing increased ICP. Which sign and symptom below is the EARLIEST indicator the patient is having this complication?

13. Select all the signs and symptoms that occur with increased ICP:

14. You’re maintaining an external ventricular drain. The ICP readings should be?

15. Which patient below with ICP is experiencing Cushing’s Triad? A patient with the following:

16. The patient has a blood pressure of 130/88 and ICP reading of 12. What is the patient’s cerebral perfusion pressure, and how do you interpret this as the nurse?

17. According to question 16, the patient’s blood pressure is 130/88. What is the patient’s mean arterial pressure (MAP)?

18. During the assessment of a patient with increased ICP, you note that the patient’s arms are extended straight out and toes pointed downward. You will document this as:

19. While positioning a patient in bed with increased ICP, it important to avoid?

20. During the eye assessment of a patient with increased ICP, you need to assess the oculocephalic reflex. If the patient has brain stem damage what response will you find?

21. A patient is receiving Mannitol for increased ICP. Which statement is INCORRECT about this medication?

22. What assessment finding requires immediate intervention if found while a patient is receiving Mannitol?