INCREASED INTRACRANIAL PRESSURE (IICP) - CUSHING’S TRIAD (Symptoms OF ICP Are Opposite OF Shock) * ICP * * Shock « t Systolic B/P Vere ¥ Pulse t Pulse ‘ Respirations t Respirations(2a scl Scan MRI ‘ * PET, EEG, Angiography) *LiGOx Brain Tissue xygenation Catheter * Transcranial Doppler Studios TP + Evokod Potential Studios \t intracranial Blood Vol. Cerebral Hemorrhage tesr Sale Toxine Cerebral Edema lechomic Cells Dilated Cerebral Arteries PCO “‘Acidotic State # Secondary to Initial Damage # Brain Tumor * Closed Head Injury ured Blood Vessels Ruy os (TTS) holon mange in L * Thrombosis & lechemia uching’s Tad ‘\s Hyarocephalue ° Pupillary Changes ‘y e * Fafledema Fs \cP Monitoring Ventriculostomy) + Cerebral Orggerattion Mon torr (LICOX) 1 Sipertone aire Ve # Medleateg= Osmotic Dretios Corncosterode Artioctaure Drage ‘->Infants_ * Bulging Fontanels * Cranial Suture Separation « THead Circumference * High Pitched Cry * Ingert Urinary i Catheter Avoid Straining ‘Sensory & Motor leacache *Vomizrg TGR Occurs With Tin The Size OF intracranial Contents (pale DR sore Prcesvone © Airway Fatency SF From Ears/Nose? leurov's *FCO2 OK? * Prevent Aspiration "© Hemniation erebral Perfusion * Diabetes Ineipidue * Som-Fowlers Minimum Suctioning § Guice Envkormens, ° Explain Neuro 's During BM * Charge Rosition Slowly * Ventilator? * Provent Eye Damage * ypceurage Fears ROM ¢ Maigean Hoaration ‘Light Sedativea for santa Realty * Presoure Ulcer Prevention sgitation Orientation * Avoid Extreme Hip Flexion * 2 Coughing, Sneezing, or Valesiva Manewer i andioace * Maintain Nutritional Needs - Enteral or Parenteral Feedings Gk te Unconscious « Assess Motor Responses and Movement * Giascow Coma Scale # TSize infant's Head * Work Thru FeelingsFAST RECOGNITION OF A STROKECRANIAL NERVE MNEMONIC S = Sensory Olfactory Optic Oculomotor Trochlear Trigeminal Abducens Facial Acoustic Gloseopharyngeal Vague Nerve Spinal Hypogloseal ZOAA000 BEB onireing Education Coneuttants, ni rrr TO445000 M = Motor On Old Olympus Towering Tope A Finn And German Viewed Some Hops B= Both 3 6 M M B M 5 & B 8 M M Some Say Marry Money But My Brother Says Bad Business Marry MoneyBELL’S PALSY Forehead Not Wrinkled Eyeball Rolls Up Eyelid Does Not Close Flat Nasgolabial Fold Paralysis of Lower Face Etiology: Possible reactivation of herpes vesicles in and around the ear will proceed facial paralysis. Treatment: * Corticosteroids ° Antivirale e Full Recovery by Most Patients in 6 Months, Especially if Treatment is Started ImmediatelyABNORMAL POSTURINGNURSING CARE FOR SPRAINS AND STRAINS R Rest Ice C Compression E ElevationThickened Synovial Al Membranes 4 Inflammation Synovitia| rN Ot Stages Sprannus +> Cartilage Destruction Fibrous —p Fibrous tissue ‘Ankylosia * which evolves into scar tissue «Ayan aa pala 2. ASSESSMENT. NSAIDS, Cox2 Inhibitors * Disease Modifying Antirneumatic Drugs (DMARDs) Af Flaqueni, Methotrexate, Enbrel, Remicade * Heat /Colt Applcacions + Bilateral joint involvement © Detontity roventing Dovicoe + Joint stitfness, pain, limitation of movement # Prysical Therapy * Morning stiffness lasting >thr * Fain increases with movement «@Serum —emm) + Commonly affects joints of hands and fingers Rheumatod Factor # Extraarticular symptoms + Teor ‘Rheumatoid nodules (located on extensor oT C-Reactive Protein surface of joints) Poatthe Antinulear * Sjdigrar's syndrome (decreased tearing, ‘Antibody dry mouth, photosensitivity) **Felty oyndrome (oplenomegaly, blood dyscraciae) BS ohiirsing Education Coeutcant heI can't sit up straight and | got this pillow Doing pretty good — between my legs! can’t crose my legs or stand too long — got to keep JOINT REPLACEMENTS MAIN COURSE me Crrar nee) Nm Knee — CPM, neutral ear DT aCe Cay do not bend hip 7 96° 008 2* post op day Incision careAsoose Extremity For ‘Color ‘T Tolerance To Meds —+ Prevent: Oversedation * LV Rate Avoid CHF fronn pee ue ae - ae Imntblity compicatons " Contractures baat Disorientation ies Seen, Gre Frobleme + Thrombophlebitio Safety —> Side Ralls ana Prevent Falls: Poor Nutrition Constipation - Fluid & eotrolyte Imbalance, Foor Healing Motor Function Pain, Muscle Spas * Circulatory Compromice ¢ Infection immobility Complications * Embol Delayed Union - Non Union # Avazcular at Emcolism Necrosis ‘Nerve and Vascular Injury TAge + Treat cooxisting medical cisorcers Cardiac problems Peripheral Vascular Disease Neurologic disorders TFemale Buckle Tractipn SiMe ose to Relieve Spasmo Para * Presence up t0 24-48 Hours TaN] Wsiian Revcvon Charge Chronic Condition Depend itor 42 Hrs nad Nici Sos coraiaan & ame + Use Asdtion Pilon Beowoon Leg ¢ Tat, Muscle Spagme, Tolge Steep Benue Acted Leg onortaned oe ‘» Adduction of Affected Leg Sutyery = Exercice When OF Estemal Rotation v * Ghent teaching, Self Care Fremenion * Deformity Along Lateral ental Foation # Avoid Extreme Hip Flexion pace, pera ins - Screws - Plates) + Prevent External Rotation is Displaces Prosthctice, ate ae + Ecchymosio HG Ovirsing Education Conoltanta ne