Treatment for Increased ICP: goal to relieve ICP by reducing cerebral edema, reducing amount of CSF, or reducing the blood volume in the brain. Maintain cerebral perfusion.
-Maintain oxygenation (decreased O2 and high CO2 cause cerebral vasodilatioon in brain > increased ICP)
-Maintain adequate cerebral perfusion (hypotension/bradycardia would decrease brain perfusion)
-Keep temp below 100.4 (38C): inc temp can inc cerebral metabolism and edema which inc ICP.
-Elevate HOB
-Keep head midline so jugular vein can drain
-Watch ICP monitor with turning client. If ICP has not come down they are not tolerating that side well.
-Avoid restraints, bowel/bladder distension, hip flexion, Valsalva, isometrics. No sneezing or nose blowing.
-Limit suctioning and coughing
-Nursing interventions should be spaced out instead of clustered: any actions increase ICP.
-Monitor GCS and vitals for Cushings triad.
-Barbiturate induced coma to decrease cerebral metabolism.
-Osmotic diuretics pull fluid from brain cells and filter through kidneys to dec ICP.
-Hypertonic saline can pull fluid from brain to reduce edema.
-Steroids: may decrease cerebral edema.
-Fluid restriction
-ICP monitoring devices: ventricular cath or subarachnoid screw. Risk of infection.