Increased Intracranial Pressure (ICP)
Increased ICP is a critical topic for the NCLEX and nursing exams due to its deadly nature and relation to many high-stakes topics.
Understanding Increased ICP
- Definition: High pressure inside the cranium (head) puts pressure on the brain.
- Can lead to compression of the brain stem, affecting breathing and heart rate, potentially fatal.
Causes of Increased ICP
- Bleeding: From aneurysm or stroke, causing blood vessel rupture and brain filling with blood.
- Swelling/Inflammation: From head trauma or meningitis.
- Increased Brain Tissue: Resulting from tumors.
Pathophysiology
- Compression of Blood Vessels: Reduced oxygen supply to the brain.
- Leads to cerebral hypoxia, causing a change in level of consciousness.
- Key Term: Altered level of consciousness or decreased mental status.
Signs and Symptoms
Early Signs (Most Tested)
- Altered level of consciousness: Irritability, restlessness, decreased mental status.
- Sleepiness, flat affect, and drowsiness.
Moderate Signs
- Constant headache.
- Sudden Vomiting: Emesis without nausea, must be reported to a healthcare provider.
- Priority Note: Vomiting without nausea is a priority finding in exams.
Late Deadly Signs
- Pressure on brain stem affects vital functions.
- Irregular Breathing: Cheyne-Stokes respirations (fast and slow breathing).
- Neck Rigidity: Stiff neck (nuchal rigidity), inability to flex chin toward chest.
- Brain Stem Affected: Fixed and dilated pupils, sometimes unequal.
Exam Focus
- Early detection of ICP is crucial as it saves lives.
- Priority Questions: NCLEX often prioritizes findings like headache and emesis without nausea.
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Acknowledgments
- Thanks to the team of experts for creating educational videos.