Increase Intracranial Pressure

patho

can be caused by

Hydrocephalus(abnormal buildup of cerebrospinal fluid)

Bleeding into the brain

Swelling in the brain

Aneurysm

Blood pooling in some part of the brain

Brain or head injury

Brain tumor

Infections such as encephalitis or meningitis

High blood pressure

ICP is an increase in the pressure inside of the skull; typically due to trauma or and/one of the reasons below:

Pharmacology

Manifestations

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Change in behavior such as extreme irritability (child is cranky, cannot be consoled or comforted)

Increased sleepiness; lethargy

Shrill or high-pitched cry

Nausea/vomitiing

headache or stiff neck when waking up

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Trouble walking or uncoordinated movements

vision changes

seizures

in neonates: bulging fontanelle, lethargy, vomiting, poor feeding

treatment dependent on cause

Carbonic anhydrase inhibitors (acetazolamide) and loop diuretics (furosemide) to reducing cerebrospinal fluid and thus ICP


Pentobarbital or other barbiturates to induce coma

Labs and Diagnostics

lumbar puncture to measure spinal fluid

CT scan

MRI

Safety considerations

airway needs to be secured immediately, along with oxygen

sedation for safety

pt will remain on bedrest until condition is stabilized

foley to prevent need for ambulation (sedated)

Expected Outcomes

Pts increased ICP will decrease

minimal (if any) deficits once waken from coma/sedation

Potential complications

seizure

stroke

neurological deficits

death

Nursing care

secure airway

keep neck stabilized

maintain body temp (unless during hypothermic therapy)

frequent vitals

monitor level of sedation

ensure hydration

monitor I&O; keep patient clean

work closely with MD to administer meds and manage pt condition

Education

educate family on cause of ICP

report for abuse if indicated

educate family about sedation/coma

educate about treatment and potential neurological deficits