Critical Care Exam 4 (Based on Study Guide) Test Test
92Questions And Answers Latest Update 2024/2025 RATED
A+
What is the Glasgow Coma Scale? - CORRECT ANSWERS What is the
Glasgow Coma Scale? A tool for assessing arousal and level of conciousness -
guides evaluation of an ill/injured patient who's status may change quickly. Score of
< 8 is indicates need for intubation. Score of 3 or less may be indicative of brain
death. *Most sensitive indicator of neurological status*
Best eye opening response - spontaneous (4), in response to speech (3), in response
to pain (2) no response (1)
Best verbal response - oriented (5) confused (4) inappropriate words (3) garbled
sounds (2) no response (1)
Best motor response - obeys commands (6), localizes stimuli (5), withdrawal from
stimulus (4), abnormal flexion (3) abnormal extension (2) no response (1)
*Intubated patients will be noted to have a score of "1T" for the best verbal
response to recognize that lack of verbalization is due to intubation
*If score is less than 8, intubation is necessary*
What is Intracranial Pressure? - CORRECT ANSWERS The pressure within the
cranial vault. *Normal is 0-15*
Over 20 is considered elevated (intracranial hypertension)
What are the contents of the cranium? - CORRECT ANSWERS Intracranial
circulation (Blood), cerebrospinal fluid, brain parenchyma
Explain cerebral autoregulation - CORRECT ANSWERS A protective
mechanism in which the brain is able to control how much blood flow it receives
over a range of blood pressures.
Vessels dilate to increase cerebral blood flow, and constrict to decrease cerebral
blood flow.
,Critical Care Exam 4 (Based on Study Guide) Test Test
92Questions And Answers Latest Update 2024/2025 RATED
A+
Damage to brain tissue and BP extremes can impair autoregulation.
Cerebral vasodilation causes increased ICP by allowing more blood into brain.
Vasodilation can be caused by hypoxia, hypercapnia and acidosis.
*^This is why it is SO important to treat hypoxia and hypercapnia quickly when a
TBI occurs!*
Extremes of blood pressure can also increase ICP, especially when autoregulation is
impaired. Blood pressure elevations occur during coughing, straining, and
suctioning.
Explain compensatory mechanisms the brain uses to decrease pressure - CORRECT
ANSWERS Shunting of CSF into spinal subarachnoid space
Increased CSF absorption
Decreased CSF production
Shunt of venous blood out of the skull
ICP may remain constant during compensation, but eventually compensation will
fail
*When ICP increases, the brain shifts within the skull, and blood supply to the brain
tissue is altered. This can lead to ischemia, anoxic injury, and herniation. This is why
high ICP is so dangerous*
What is herniation? - CORRECT ANSWERS The displacement of tissue
through structures within the skull. The most common types are uncal and central,
which both result in compression of the brain stem
How will a patient with increased ICP present? - CORRECT ANSWERS *The
most sensitive sign is change in level of consciousness*
-Deterioration in all aspects of neurological functioning
-Restlessness, confusion, combativeness (initial)
, Critical Care Exam 4 (Based on Study Guide) Test Test
92Questions And Answers Latest Update 2024/2025 RATED
A+
-Sluggish/fixed pupillary reactions
-Declined motor function
-Changes in vital signs are a LATE finding
-Cushing's triad: increased systolic, bradycardia, widened pulse pressure
(IMPENDING HERNIATION)
-Increased stimuli to arouse
How is Intracranial pressure monitored? - CORRECT ANSWERS ICP
monitoring is invasive, monitors pressure in cranium, helps to calculate CPP, can
drain CSF.
Can be preformed with a fluid filled system connected to an external transducer
(EVD), or a fiberoptic system(BOLT).
Infection must be prevented during ICP monitoring by use of aseptic technique
when handling system!!!
Fiberoptic systems do not require leveling. The external transducer system must be
leveled at the ear canal or outer canthus of the eye. *Leveling is important, if
transducer is too low, it will read a low ICP. If transducer is too high, it will read a
high ICP*
-Sustained periods of ICP > 20 are considered significant
-Sustained periods of ICP > 60 are usually fatal
What is CPP? - CORRECT ANSWERS Cerebral pulse pressure.
*CPP = MAP - ICP*
Normal reading is *60-100*
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