4/11/25, 8:40 NUR480 FINAL Flashcards |
PM
NUR480 FINAL EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS
Save
Terms in this set (175)
Central nervous system Brain and spinal cord
Sensory and motor neurons
Peripheral nervous system
Encompasses the autonomic nervous system (sympathetic and parasympathetic)
Brain supplied blood through carotid arteries and supplied by vertebral arteries
Brain has no storage of glucose or anything, so it needs a constant supply of
Cerebral blood flow
blood
Circle of willis - arterial circle
Ability to maintain perfusion in the body
Cerebral autoregulation - modification of local blood vessels to regulate
Autoregulation
circulation - which may further cause issues in some instances
MAP needs to be btwn 70-110
CPP = MAP - ICP
Pressure needed to maintain blood flow to the brain
MAP pushes blood INTO the brain
Cerebral Perfusion Pressure (CPP) ICP pushes blood OUT of the brain
NORMAL ICP - 0-10/15
NORMAL CPP - 70-100 (70-80 is perfect)
IF MAP = ICP then NO PERFUSION
1/18
,4/11/25, 8:40 NUR480 FINAL Flashcards |
PM
Post-neuro assess q15-30 until stable
Flat 2-3 hour
Encourage fluids
Lumbar puncture
Oral analgesics for headache
CONTRAINDICATED in INCREASED ICP
- Gait and Stance
- Heel to toe walk
- Romberg Test
Cerebellar assessment - Pronator Drift
- Rapid Alternating Movement
- Finger to Nose Test
- Heel to Shin Test
When one of the contents of the skull (ie blood, brain, CSF) increases, another
must decrease to compensate and maintain normal ICP
Monroe-Kellie Doctrine
UNDER NORMAL CIRCUMSTANCES
ICP > arterial BP
Blood flow cuts off
Vasomotor neurons increase MAP in attempt to increase CPP which leads to
CUSHING'S TRIAD
Increased ICP Cushing's triad - INCREASED SBP (widening pulse pressures)
DECREASED HR
DECREASED RR
COMPLICATIONS INCLUDE:
Brainstem herniation/compression
Diabetes Insipidus
SIADH
Everything points to the core
Decorticate posturing 1st seen in INCREASED ICP
Damage to the Cerebral CORTEX
Decerebrate posturing Everything is extended, damage to the upper brain stem
Shifting of brain tissue - may be caused by Cushing's
Triad MANIFESTATIONS
- unresponsive coma
Cerebral Herniation
- apnea
- isoelectric EEG
- no cephalic reflexes
MAY CAUSE brainstem compression, brain death, + babinski reflex
2/18
, 4/11/25, 8:40 NUR480 FINAL Flashcards |
PM
DECREASE cerebral edema BY:
Osmotic diuretics (mannitol, 3% hypertonic saline)
Fluid restriction
Dexamethasone to reduce edema
FEVER CONTROL
DECREASED volume of CSF BY:
Drainage
Positioning is individualized
Management of Increased ICP
HOB 30-45, neutral neck
NO SHARP HIP FLEXION
NO Valsalva maneuver (stool softener, etc.)
Suction only if necessary NO MORE than 15 sec
AVOID HIGH PEEP
Cluster care
Craniotomy
Surgical management of Increased ICP Burr holes
Hemicraniotomy w/ durotomy
Ventriculostomy or External Ventricular Drain (EVD) - Monitors ICP and DRAINS
CSF/blood - zero line placed at TRAGUS
Invasive monitoring of ICP Subarachnoid bolt - NO ventricular puncture and avoids complications from brain
shift
Epidural/Subdural catheter - MONITORS ICP ONLY
Primary: Injury that occurs right away
Direct contact to the head/brain
Secondary: develops over time, hours to days from initial injury
Result from inadequate perfusion
Traumatic Brain Injury
Avoid NGT placement
ENTERAL nutrition
SEIZURE precautions
VTE prophylaxis
Occurs with or without brain damage
Skull Fractures
Basal skull fracture is most common
BATTLE SIGN, CSF otorrhea/rhinorrhea
Impact of brain against skull that causes bruising
Brain contusions
Peak of injury is 18-36 HOURS after insult
May lead to cerebral hemorrhage, edema, and increased ICP
3/18
PM
NUR480 FINAL EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS
Save
Terms in this set (175)
Central nervous system Brain and spinal cord
Sensory and motor neurons
Peripheral nervous system
Encompasses the autonomic nervous system (sympathetic and parasympathetic)
Brain supplied blood through carotid arteries and supplied by vertebral arteries
Brain has no storage of glucose or anything, so it needs a constant supply of
Cerebral blood flow
blood
Circle of willis - arterial circle
Ability to maintain perfusion in the body
Cerebral autoregulation - modification of local blood vessels to regulate
Autoregulation
circulation - which may further cause issues in some instances
MAP needs to be btwn 70-110
CPP = MAP - ICP
Pressure needed to maintain blood flow to the brain
MAP pushes blood INTO the brain
Cerebral Perfusion Pressure (CPP) ICP pushes blood OUT of the brain
NORMAL ICP - 0-10/15
NORMAL CPP - 70-100 (70-80 is perfect)
IF MAP = ICP then NO PERFUSION
1/18
,4/11/25, 8:40 NUR480 FINAL Flashcards |
PM
Post-neuro assess q15-30 until stable
Flat 2-3 hour
Encourage fluids
Lumbar puncture
Oral analgesics for headache
CONTRAINDICATED in INCREASED ICP
- Gait and Stance
- Heel to toe walk
- Romberg Test
Cerebellar assessment - Pronator Drift
- Rapid Alternating Movement
- Finger to Nose Test
- Heel to Shin Test
When one of the contents of the skull (ie blood, brain, CSF) increases, another
must decrease to compensate and maintain normal ICP
Monroe-Kellie Doctrine
UNDER NORMAL CIRCUMSTANCES
ICP > arterial BP
Blood flow cuts off
Vasomotor neurons increase MAP in attempt to increase CPP which leads to
CUSHING'S TRIAD
Increased ICP Cushing's triad - INCREASED SBP (widening pulse pressures)
DECREASED HR
DECREASED RR
COMPLICATIONS INCLUDE:
Brainstem herniation/compression
Diabetes Insipidus
SIADH
Everything points to the core
Decorticate posturing 1st seen in INCREASED ICP
Damage to the Cerebral CORTEX
Decerebrate posturing Everything is extended, damage to the upper brain stem
Shifting of brain tissue - may be caused by Cushing's
Triad MANIFESTATIONS
- unresponsive coma
Cerebral Herniation
- apnea
- isoelectric EEG
- no cephalic reflexes
MAY CAUSE brainstem compression, brain death, + babinski reflex
2/18
, 4/11/25, 8:40 NUR480 FINAL Flashcards |
PM
DECREASE cerebral edema BY:
Osmotic diuretics (mannitol, 3% hypertonic saline)
Fluid restriction
Dexamethasone to reduce edema
FEVER CONTROL
DECREASED volume of CSF BY:
Drainage
Positioning is individualized
Management of Increased ICP
HOB 30-45, neutral neck
NO SHARP HIP FLEXION
NO Valsalva maneuver (stool softener, etc.)
Suction only if necessary NO MORE than 15 sec
AVOID HIGH PEEP
Cluster care
Craniotomy
Surgical management of Increased ICP Burr holes
Hemicraniotomy w/ durotomy
Ventriculostomy or External Ventricular Drain (EVD) - Monitors ICP and DRAINS
CSF/blood - zero line placed at TRAGUS
Invasive monitoring of ICP Subarachnoid bolt - NO ventricular puncture and avoids complications from brain
shift
Epidural/Subdural catheter - MONITORS ICP ONLY
Primary: Injury that occurs right away
Direct contact to the head/brain
Secondary: develops over time, hours to days from initial injury
Result from inadequate perfusion
Traumatic Brain Injury
Avoid NGT placement
ENTERAL nutrition
SEIZURE precautions
VTE prophylaxis
Occurs with or without brain damage
Skull Fractures
Basal skull fracture is most common
BATTLE SIGN, CSF otorrhea/rhinorrhea
Impact of brain against skull that causes bruising
Brain contusions
Peak of injury is 18-36 HOURS after insult
May lead to cerebral hemorrhage, edema, and increased ICP
3/18
