Questions: 1.MAP is 80 and ICP is 10.What is the CPP? A:70mmhg
2.What is normally the first clinical manifestation of IICP? A:Dcresed LOC.
3.Name the three main monitoring systems for ICP? A:Epidural probe, subarachnoid screw, intraventricular catheter.
4.Name the two chemical restraints to control restlessness and agitation and keep B/P, ICP and cerebral metabolism from increasing. A:Sedation and paralysis.
5.To maintain adequate oxygenation, partial pressure of arterial O2 and CO2 should be maintained at what value? A:100mmhg arterial O2, 35mmhg arterial CO2.
I had a patient whos mother had died of lung cancer. The patient had smoked her entire adult life and had COPD. She told me she would not stop smoking because her mom did not smoke a day in her life. Her moms two husbands, one being the patients father, had been heavy smokers however. As a non smoker it is hard to understand this kind of mind set. I have tried it in my wilder days, and just don't understand the attraction other than a head rush. I do understand how hard it is to quit smoking from friends and family who are smokers and have tried. Some have and some havn't even faced with serious health risks.
Perfusion:
1.I:Elevate head of bed 30 degrees.R:To promote circulation to lower extremities.
2.I:Check peripheral pulses every 4hrs.R:Palpable, strong peripheral pulses indicate good arterial flow.
3.I:Encourage ambulation.R:Encourages circulation to extremities.
Cellular Regulation:
1.I:Instruct and help patient to alternate periods of rest and activity.R:To reduce the bodys O2 demand and prevent fatigue.
2.I:Maintain awareness and sensitivity to threat of death from patient.R:To recognize, respect and cope with patients emotions.
3.I:Provide gentle oral hygiene.R:To avoid injury and bleeding of oral mucosa.
Medication:
Warfarin. Patient with high risk of embolization.
1.I:Do not interchange brands of medication.R:Potencies may not be equivalent.
2.I:Instruct patient on importance of frequent lab tests.R:To monitor coagulation factors.
3.I:Monitor patients over age 60 for side effects at lower therapeutic ranges.R:Older patients exhibit greater PT/INR response.