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