Intracranial Pressure || A+ Guaranteed.
1. Which components can change to adapt to small increases in intracranial pressure (ICP) (select
all that apply)?
a. Blood
b. Skull bone
c. Brain tissue
d. Scalp tissue
e. Cerebrospinal fluid (CSF) correct answers a, c, e. Blood adapts with increased venous outflow,
decreased cerebral blood flow (CBF), and collapse of veins and dural sinuses. Brain tissue adapts
with distention of the dura, slight compression of tissue, or herniation. Cerebrospinal fluid (CSF)
adapts with increased absorption, decreased production, and displacement into the spinal canal.
Skull bone and scalp tissue do not adapt to changes in intracranial pressure (ICP).
The cerebral perfusion pressure (CPP) is the pressure needed to ensure blood flow to the brain.
Normal CPP is 60 to 100 mm Hg. Calculate the CPP of a patient whose BP is 106/52 mm Hg and
ICP is 14 mm Hg. ________________________________________________ mm Hg correct
answers 56 mm Hg
Calculate the CPP for the patient with an ICP of 34 mm Hg and a systemic BP of 108/64 mm Hg.
________________________________________________ mm Hg correct answers 45 mm Hg
Which factors decrease cerebral blood flow (select all that apply)?
a. Increased ICP
b. Partial pressure of oxygen in arterial blood (PaO2) of 45 mm Hg
c. Partial pressure of carbon dioxide in arterial blood (PaCO2) of 30 mm Hg
d. Arterial blood pH of 7.3 e. Decreased mean arterial pressure (MAP) correct answers a, c, e.
Cerebral blood flow is decreased when the MAP and the partial pressure of carbon dioxide in
arterial blood (PaCO2) are decreased and ICP is increased. The other options increase cerebral
blood flow
What are causes of vasogenic cerebral edema (select all that apply)?
, a. Hydrocephalus
b. Ingested toxins
c. Destructive lesions or trauma
d. Local disruption of cell membranes
e. Fluid flowing from intravascular to extravascular space correct answers b, e. A variety of
insults, such as brain tumors, abscesses, and ingested toxins, lead to vasogenic cerebral edema. It
is the most common type of cerebral edema and characterized by leakage of macromolecules
from the capillaries into the surrounding extracellular space. This results in an osmotic gradient
that favors the flow of fluid from the intravascular to the extravascular space. Hydrocephalus
causes interstitial cerebral edema. Destructive lesions or trauma destroy cell membranes and
cause cytotoxic cerebral edema.
Which events cause increased ICP (select all that apply)?
a. Vasodilation
b. Necrotic cerebral tissue
c. Blood vessel compression
d. Edema from initial brain insult
e. Brainstem compression and herniation correct answers a, b, d. Increased ICP is caused by
vasodilation and edema from an initial brain insult or necrotic tissue. Blood vessel compression
and brainstem compression and herniation occur because of increased ICP.
An early sign of increased ICP that the nurse should assess for is
a. Cushing's triad.
b. unexpected vomiting.
c. decreasing level of consciousness (LOC).
d. dilated pupil with sluggish response to light. correct answers c. One of the most sensitive signs
of increased ICP is a decreasing level of consciousness (LOC). A decrease in LOC will occur
before changes in vital signs, ocular signs, or projectile vomiting occur.
The nurse recognizes the presence of Cushing's triad in the patient with which vital sign
changes?
1. Which components can change to adapt to small increases in intracranial pressure (ICP) (select
all that apply)?
a. Blood
b. Skull bone
c. Brain tissue
d. Scalp tissue
e. Cerebrospinal fluid (CSF) correct answers a, c, e. Blood adapts with increased venous outflow,
decreased cerebral blood flow (CBF), and collapse of veins and dural sinuses. Brain tissue adapts
with distention of the dura, slight compression of tissue, or herniation. Cerebrospinal fluid (CSF)
adapts with increased absorption, decreased production, and displacement into the spinal canal.
Skull bone and scalp tissue do not adapt to changes in intracranial pressure (ICP).
The cerebral perfusion pressure (CPP) is the pressure needed to ensure blood flow to the brain.
Normal CPP is 60 to 100 mm Hg. Calculate the CPP of a patient whose BP is 106/52 mm Hg and
ICP is 14 mm Hg. ________________________________________________ mm Hg correct
answers 56 mm Hg
Calculate the CPP for the patient with an ICP of 34 mm Hg and a systemic BP of 108/64 mm Hg.
________________________________________________ mm Hg correct answers 45 mm Hg
Which factors decrease cerebral blood flow (select all that apply)?
a. Increased ICP
b. Partial pressure of oxygen in arterial blood (PaO2) of 45 mm Hg
c. Partial pressure of carbon dioxide in arterial blood (PaCO2) of 30 mm Hg
d. Arterial blood pH of 7.3 e. Decreased mean arterial pressure (MAP) correct answers a, c, e.
Cerebral blood flow is decreased when the MAP and the partial pressure of carbon dioxide in
arterial blood (PaCO2) are decreased and ICP is increased. The other options increase cerebral
blood flow
What are causes of vasogenic cerebral edema (select all that apply)?
, a. Hydrocephalus
b. Ingested toxins
c. Destructive lesions or trauma
d. Local disruption of cell membranes
e. Fluid flowing from intravascular to extravascular space correct answers b, e. A variety of
insults, such as brain tumors, abscesses, and ingested toxins, lead to vasogenic cerebral edema. It
is the most common type of cerebral edema and characterized by leakage of macromolecules
from the capillaries into the surrounding extracellular space. This results in an osmotic gradient
that favors the flow of fluid from the intravascular to the extravascular space. Hydrocephalus
causes interstitial cerebral edema. Destructive lesions or trauma destroy cell membranes and
cause cytotoxic cerebral edema.
Which events cause increased ICP (select all that apply)?
a. Vasodilation
b. Necrotic cerebral tissue
c. Blood vessel compression
d. Edema from initial brain insult
e. Brainstem compression and herniation correct answers a, b, d. Increased ICP is caused by
vasodilation and edema from an initial brain insult or necrotic tissue. Blood vessel compression
and brainstem compression and herniation occur because of increased ICP.
An early sign of increased ICP that the nurse should assess for is
a. Cushing's triad.
b. unexpected vomiting.
c. decreasing level of consciousness (LOC).
d. dilated pupil with sluggish response to light. correct answers c. One of the most sensitive signs
of increased ICP is a decreasing level of consciousness (LOC). A decrease in LOC will occur
before changes in vital signs, ocular signs, or projectile vomiting occur.
The nurse recognizes the presence of Cushing's triad in the patient with which vital sign
changes?
