Neurological Assessment, Increased Intracranial Pressure, and Intracranial Surgery

Flashcards covering altered level of consciousness, increased intracranial pressure signs and complications, and intracranial surgical precautions.

How is altered level of consciousness (Altered LOC) classified?

It is not a condition, but a symptom.

How is 'solemness' defined?

An unnatural level of sleepiness.

How is 'lethregy' defined?

Excessively drowsy, slow, sluggish.

What is the definition of 'stupar'?

Minimal responsiveness with no spontaneous movement.

How is 'semi coma' characterized compared to stupor?

It is similar to stupor, but the patient only responds to very very strong stimulation.

What are the main causes of altered level of consciousness (Altered LOC)?

Neurological (head injuries / stroke), toxicology (alcohol / drugs), and metabolic (renal failure).

What do normal pupils indicate in a patient with altered level of consciousness?

A metabolic or toxic cause.

What are the physical manifestations and involved brain location for decorticate posturing?

Arms brought into the core and feet extended; indicates a cerebral hemisphere location.

What are the physical manifestations and involved brain location for decerebrate posturing?

Arms rotated out and extended with rigid legs; indicates a brain stem location.

Why should a nurse tape a patient's eyelids shut during care for altered LOC?

To keep the eyes moist.

What are the percentage components that make up intracranial volume?

$80\%$ brain, $10\%$ CSF, and $10\%$ blood.

What is the #1 sign of increased intracranial pressure (IICP)?

Altered LOC (Altered level of consciousness).

What are the three components of the Cushing Triad?

Elevated systolic blood pressure with widening pulse pressure, bradycardia, and irregular respirations.

What life-threatening complication can increased intracranial pressure (IICP) lead to?

Brainstem herniation.

What are the characteristics of Diabetes Insipidus as an IICP complication?

Dry inside, elevated $\text{Na}^+$, and low ADH.

What are the characteristics and treatment for SIADH as an IICP complication?

Soaked inside, decreased $\text{Na}^+$, seizures, and elevated ADH; treated with $3\%$ $\text{Na}^+$.

What medication is given to reduce inflammation around the brain in patients with ICP?

Decadron.

What brain structure is involved in supratentorial surgery, and how should the head of bed (HOB) be positioned?

Cerebrum; elevate head of bed $30\text{--}45\%$.

What brain structure is involved in infatentorial surgery, and what positioning restriction applies?

Cerebellum; do not flex neck.

How is transphenoidial surgery performed, and what post-op precaution must the patient follow?

Performed through the nasal cavity or upper lip; the patient cannot blow their nose.

What is the targeted systolic blood pressure range for a patient undergoing transphenoidial surgery care?

Systolic B/P $90\text{--}140$.