By ExamNavigator - By ExamNavigator Healthstream ICU Knowledge 1. ...

Healthstream ICU Knowledge

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Healthstream ICU Knowledge

1. Intracranial hemorrhage's goal for treatment?: Stop bleeding. Decrease icp.

• Subdural hematoma?: bleeding between covering of brain (dura) and surface of brain.

Compress brain tissue , leadin to brain dead. Most pt do not recover.

• Epidural hematoma?: covering of the brain (dura) peel away from skull (from skull

fracture). Wake up and die. Changes in vital signs are late signs.

• SubArachnoid hemorrhage (SAH)?: aneurysm of artery in brain, causing rup- ture. This is a

type of hemorhagic stroke. Risk for repeated bleeding is 35% within. First 14 days post first bleed. Vasospasm is a common complication of SAH. Cerebral angiogram can dx cerebral aneurysm. A ruptured aneurysm has a risk for death of 40% , 08% disable after rupture.

• Normal ICP for adult?: less than 15mmHg. When treating high ICP, the goal is to be 20

mmHg ICP.

• What is cushing's triad?: three symptoms that indicate brian damage from high ICP.

BRADYCARDIA, RESP DEPRESSION, HYPERTENSION.

7. What factors increase ICP?: suction, any stimulations.

8. Glascow score of 5 indicate?:

• Cerebral angiogram?: visualize cerebral blood flow and blood vessels. Can remove clot in

bv at time of process. Insertion of dye through femoral artery. Pt lies flat. Indicated for: atherosclerosis, dissection, tumor, aneurysm, av malformation, stroke. Not for kidney failure, bleeding issue, allergic to dye (iodine& shellfish). Cerebral angiogram can dx cerebral aneurysm. A ruptured aneurysm has a risk for death of 40% , 08% disable after rupture.

• Av malformation?: l connection between artery and vein without capillary bed between in

brain blood vessels. Leading to high pressure in veins (as vein is receiving blood too quick!-> weaken bv-> risk aneurysm.

• WHY IS AVM BAD?: 1 risk of aneurysm rupture. 2 enlarged avm will put pressure on

surrounding brain. 3 cells that only gets oxy from capillary bed will die.

12. Types of AV MALFORMATION?: dural fistula, venous malformation, caver- noma,

capillary telangiectasia.

13. two locations of AVM?: BRAIN & SPINE.

• treatment for avm?: embolization - deliver glue/ obstructive materials into avm, thus, blood

cant flow into avm to cause rupture.

• what test is used to locate what part of the brain is damaged by seizure or stroke. this test

combines both neuroimaging anf neuropsychological tests?- : wada test- inject barbiturate into carotid artery to shut down one brian hemisphere and evaluate the opposite hemisphere..

• How to know if a person will be allergic to angiogram dye?: allergic to iodine and shellfish.

• A pt with cerebral aneurysm is dx. What can the medical team do to secure it in preventing

rupture of the aneurysm?: clipping , endovascular coiling.

18. What is the procedure of opening the skull?: craniotomy.

• What is clipping?: clip at the neck of aneurysm to block normal blood floe from entering;

thus, stop it from stretching further and eventually rupture.

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