INCREASED Evaluating pupil response

DILATED PUPIL
INTRACRANIAL PRESSURE
(ICP)
 a rise in pressure around the brain.
 in the Cerebrospinal Fluid (CSF)
volume, Blood entering the CSF,
Cerebral Edema, Head trauma or
Infection, space-occupying lesions Determining LOC
such as brain tumors, or the
development of Hydrocephalus or
Guillain-Barré Syndrome.

ASSESSMENT

 Obtaining Vital Signs

 Evaluating pupil response
 Determining levels of consciousness
 Motor and Sensory function
 Electronic Monitoring (Subarachnoid
screw, Epidural Sensor, Intraventricular
catheter, Intraparenchymal
monitoring) SIGNS AND SYMPTOMS
VITAL SIGNS  Increased head circumference
 Increase Temperature  Fontanelle changes
 Decrease Pulse  Vomiting
 Eye Changes
 Decrease Respiratory
 Vital Sign Changes
 Increase Pulse Pressure
 Pain (Headache)
 Mentation (Irritability)

SIGNS OF INCREASED ICP IN INFANTS

 Separated sutures of the skull

 Fontanel bulge outward
THERAPEUTIC MANAGEMENT

 The cause of ICP must be identified

and remedied as quickly as possible to
prevent brain injury or compression to
the brain-stem, which can lead to
both cardiac and respiratory failure.
 Actions such as coughing, vomiting,
and sneezing and rapid administration
of intravenous (IV) fluid increase ICP.
 When a parent is burping an infant
after a feeding, caution them to be
careful not to put pressure on the
jugular veins because this is another
action that increases ICP.
 Placing a child in a semi-Fowler's
position (use an infant seat for babies).

MEDICAL INTERVENTION

 Corticosteroid
o Dexamethasone (Decadron)
 Effectiveness:
o Lowering ICP
o Reduce cerebral Edema
 Osmotic Diuretics
o Mannitol
 Effectiveness:
o Reduces pressure