Ineffective Cerebral Tissue Perfusion
@article{Almeida2015ClinicalIT, title={Clinical indicators to monitor patients with risk for ineffective cerebral tissue perfusion. }, author={Miriam de Abreu Almeida and Marcos Barragan da Silva and Bruna Paulsen Panato and Ana Paula de Oliveira Siqueira and Mariana Palma da Silva and Bruna Engelman and Isis Marques Severo and Aline Tsuma Gaedke Nomura}, journal={Investigacion y educacion en enfermeria}, year={2015}, volume={33 1}, pages={ 155-63}} OBJECTIVE Select and validate the clinical indicators to monitor patients on risk for ineffective cerebral tissue perfusion, according to the Nursing Outcomes Classification (NOC). METHODOLOGY Validation study carried out between November 2012 and August 2013, in a Brazilian hospital. Seventeen judges nurses evaluated the clinical indicators of Nursing Outcomes, according to NOC for patients on risk for ineffective cerebral tissue perfusion. In the first stage, were selected the nursing… CONTINUE READING
Ineffective cerebral tissue perfusion
[3] Outside of the limits of autoregulation, raising MAP raises CBF and raising ICP lowers it (this is one reason that increasing ICP in traumatic brain injury is potentially deadly). In trauma some recommend CPP not go below 70 mmHg. [4] [5] Recommendations in children is at least 60 mmHg. [4] Within the autoregulatory range, as CPP falls there is, within seconds, vasodilatation of the cerebral resistance vessels, a fall in cerebrovascular resistance and a rise in cerebral-blood volume (CBV), and therefore CBF will return to baseline value within seconds (see as ref. Aaslid, Lindegaard, Sorteberg, and Nornes 1989:). These adaptations to rapid changes in blood pressure (in contrast with changes that occur over periods of hours or days) are known as dynamic cerebral autoregulation. [3] Footnotes [ edit] ^ a b Steiner, LA; Andrews, PJ (2006). "Monitoring the injured brain: ICP and CBF". British Journal of Anaesthesia. 97 (1): 26–38. doi: 10. 1093/bja/ael110. PMID 16698860. ^ Duschek, S; Schandry, R (2007).
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Decreased blood flow to the mesenteric artery can result in GI dysfunction, eg loss of peristalsis. Decrease input / persistent nausea may result in a decrease in circulating volume, which have a negative impact on perfusion and organ.
Hydrocephalus Hydrocephalus is a condition wherein there is an interruption to the normal flow, absorption, and production of the brain's CSF (Cerebrospinal Fluid), which is the medium that carries all the nutrients needed by the brain to remain healthy and fully-functional. If there's an interruption or overproduction of CSF - such as in hydrocephalus - it will build up inside the brain that is shown through the swelling of a child's or adult's skull. Hydrocephalus of one kind or another is especially prevalent at the two extremes of the life cycle -- in the very young and the very old -- but can occur at any age. In infancy, hydrocephalus can be caused by malformed brain-tissue. In contrast, adults with hydrocephalus were usually born with normal brain anatomy, but acquired a blockage due to a tumor, injury, bleed or infection. However, many cases of hydrocephalus in adults occur without a history of these preceding illnesses. All of these ventricles, passageways, and spaces are filled with a special fluid called cerebrospinal fluid (CSF).
(Smeltzer, pg: 1859) Elevating the head of the bed prevents aspiration. (Smeltzer, pg:1860) Recent evidence shows that a routine of oral care decreases ventilator-associated pneumonia. (Smelzter, pg: 1862) Fluid balances have to be maintained to ensure pt. doesn't get overloaded or deficit and nutrition is needed for recovery. (Smeltzer, pg: 1862)______________________________ Client Response: Monitored q 8 hours. Pt. is prescribed Cerebyx 70 mg, IV every 8 hours and Depacon 100 ml/hr, IV BID. Shifted pt. q 2 hours. Pt. was unresponsive during stimulating and repositioning. Unresponsive to voice and generalized response to pain with sluggish pupil response. Radial and pedal pulses present. Blood pressure 159/96 and heart rate 118. Pt. 's head of bed is positioned at 30 degrees to maintain a good airway. Physician prescribed a sage oral care kit q 4 hours. Adequate amounts of urine output and tube feedings are being digested. ___________________
Ineffective cerebral tissue perfusion concept map
Perform endotracheal or nasotracheal suctioning to maintain airway. Loosen clothing to prevent restricted breathing. Apply oxygen as appropriate to maintain oxygenation and prevent hypoxia. Monitor postictal period duration and characteristics because neurologic damage can affect postictal breathing pattern. 4. ineffective self-health management related to drug therapy and lifestyle adjustments. Knowledge of specific disease process Precautions to prevent complications of disease Available support groups Appraise the patient's current level of knowledge related to specific disease process to establish learning needs. Discuss lifestyle changes (e. g., avoidance of precipitating factors, driving restrictions, wearing medical ID tags, moderation in drinking and eating, exposure to stress, and avoidance of hazardous activities) that may be required to prevent future complications and/ or control the disease process. Discuss therapy/treatment options and describe rationale behind management/treatment options so patient and family can make lifestyle modifications to manage a chronic disease.
"Reduced brain perfusion and cognitive performance due to constitutional hypotension". Clinical Autonomic Research. 17 (2): 69–76. 1007/s10286-006-0379-7. PMC 1858602. PMID 17106628. ^ a b van Beek, AH; Claassen, JA; Rikkert, MG; Jansen, RW (June 2008). "Cerebral autoregulation: An overview of current concepts and methodology with special focus on the elderly". Journal of Cerebral Blood Flow & Metabolism. 28 (6): 1071–85. 1038/jcbfm. 2008. 13. PMID 18349877. ^ a b Tolias, C; Sgouros, S (2003). "Initial evaluation and management of CNS injury".. Archived from the original on March 2, 2007. Retrieved 2007-03-19. ^ Czosnyka, M; Pickard, JD (2004). "Monitoring and interpretation of intracranial pressure". Journal of Neurology, Neurosurgery, and Psychiatry. 75 (6): 813–21. 1136/jnnp. 2003. 033126. PMC 1739058. PMID 15145991. References [ edit] Sanders, MJ; McKenna, K (2001). "Ch. 22: Head and Facial Trauma". Mosby's Paramedic Textbook (2nd revised ed. ). Mosby. Walters, FJM (1998). "Intracranial Pressure and Cerebral Blood Flow".
1. Risk for Injury related to: loss of consciousness during seizure activity and postical physical weakness. Outcomes: Describes precipitating seizure factors Avoids seizure triggers/risk factors. Uses medications as prescribed. Obtains medical attention immediately if seizure frequency increases. Implements safety practices in environment. Interventions: Monitor compliance in taking antiseizure medications to determine risk for seizures. Remove potentially harmful objects from the environment. Keep suction, Ambu bag, oral or nasopharyngeal airway at bedside to maintain airway and oxygenation if needed. Use padded side rails to prevent injury during a seizure. Instruct patient to carry medication alert card to provide information in case of emergency. Remain with patient during seizure to protect patient from injury. Guide movements to prevent injury during a seizure. Monitor neurological status to identify any deficits resulting from seizure. Record seizure characteristics: body parts involved, motor activity, and seizure progression.