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Increased Intracranial Pressure

الكلية كلية التمريض     القسم قسم التمريض العام     المرحلة 3
أستاذ المادة شذى سعدي محمد نادر       25/04/2015 09:25:50
Definition. The cranium is a closed cavity filled with contents that are virtually noncompressible. غير قابل للانضغاط
This increased pressure may result from edema, bleeding, trauma, or space-occupying lesions.(SOL)
Once the pressure exceeds the accommodation point, the brain will herniate through weak points . Irreversible neurological damage or death will result.
1) Change in level of consciousness.

(b) diminished response to environmental stimuli.

(c) Responsiveness ranges from alert and oriented to no response to stimuli.

(d) Confusion, restlessness, disorientation, and drowsiness may be signs of an impending change.

(2) Headache--increases in severity with coughing, sneezing, or straining at stool.

(3) Vomiting.
ICP signs and symptoms
(4) Papilledema/pupil changes.

(b) Pupil on the affected side may be nonreactive.

(c) Pupils may be unequal, dilated, pinpoint, or nonreactive.

(d) Elevation of blood pressure with a widened pulse pressure. 

(e) Decreased pulse rate (may be increased initially).

(f) Decreased respiratory rate (may be irregular).
Nursing Management
1) Monitor vital signs closely.
(a) Accurately assess and document neurological status.
(b) Evaluation of alterations of consciousness

(2) Maintain patent airway.
(a) Intubation and hyperventilation may be indicated to provide adequate cerebral perfusion of oxygenated blood and decrease carbon dioxide induced vascular spasm.
(b) position the patient on his side to decrease the possibility of airway occlusion; use oral or nasopharyngeal airway, prn.
(c) Be aware that stimulation of coughing when suctioning increases intracranial pressure and may precipitate seizure activity.

3) Administer medications as ordered.
(a) Mannitol (osmotic diuretic, to decrease cerebral edema).
(b) Corticosteroids (to reduce cerebral edema).
(c) Dilantin (as a precautionary measure to prevent seizure activity).
(d) Antibiotics.
(4) Elevate head of bed (30?).
(a) Promotes return of venous blood.

5) Administer hypertonic I.V. solutions as ordered.
(a) Dextrose in water (hypotonic) crosses the blood-brain barrier and increase cerebral edema and intracranial pressure.
(b) Fluids will be restricted to reduce intracranial pressure.
(c) Accurate intake and output records must be kept.

(6) Protect patient from injury should seizures occur.
(a) Pad side rails.
(b) Secure a tongue blade to the head of the bed for easy access.

(7) Maintain normal body temperature.


Patient Education ICP
Family members of patients who return home following injury to the head should be instructed to return the patient to the hospital if any of the following problems occur.
(1) Fever
(2) Pulse less than 50 beats per minute.
(3) Vomiting.
(4) Slurred speech.
(5) Dizziness.
(6) Blurred or double vision.
(7) Unequal pupil size.
(8) Blood or fluid discharge from ears or nose.
(9) Increased sleepiness.
(10) Inability to move extremities.
(11) Convulsions.
(12) Unconsciousness


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .