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% Document Info
\author{kellygonzii}
\pdfinfo{
  /Title (increased-intracranial-pressure-iicp.pdf)
  /Creator (Cheatography)
  /Author (kellygonzii)
  /Subject (Increased Intracranial Pressure (IICP) Cheat Sheet)
}

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\noindent
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\begin{tabulary}{5.8cm}{C}
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Increased Intracranial Pressure (IICP) Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{kellygonzii} via \textcolor{DarkBackground}{\uline{cheatography.com/175648/cs/36855/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}kellygonzii \\
  \uline{cheatography.com/kellygonzii} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 2nd February, 2023.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{PATHOPHYSIOLOGY}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{In adults, the rigid cranial cavity created by the skull is normally filled with three essentially {\emph{noncompressible}} elements: the brain (85\%), CSF (5\%), and blood (10\%).} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{A state of dynamic equilibrium exists.} \tn 
% Row Count 5 (+ 1)
% Row 2
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\mymulticolumn{1}{x{5.377cm}}{If the volume of any of these components ↑, the volume of the others must ↓ to maintain normal pressures in the cranial cavity.} \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Monro-Kellie hypothesis}}: If volume ↑ in any of brain, CSF, or blood → volume of others must ↓} \tn 
% Row Count 11 (+ 3)
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\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{ETIOLOGY}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Brain requires constant supply of oxygen and glucose If blood flow interrupted → ischemia, disruption of cerebral metabolism.} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Compensatory mechanisms to maintain blood flow when ICP increases} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{‣ Pressure autoregulation} \tn 
% Row Count 6 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{‣ Chemical autoregulation} \tn 
% Row Count 7 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{‣ Displacement of some CSF to spinal subarachnoid space} \tn 
% Row Count 9 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{‣ Increased CSF absorption} \tn 
% Row Count 10 (+ 1)
% Row 6
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\mymulticolumn{1}{x{5.377cm}}{Autoregulatory mechanisms have limited ability to maintain cerebral blood flow} \tn 
% Row Count 12 (+ 2)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CAUSES}}  \tn
% Row 0
\SetRowColor{LightBackground}
Head injury & Cerebral edema \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Hydrocephalus & ‣ Imbalance between production/absorption of CSF \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
Excess CSF & ‣ Congenital or acquired \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
Brain tumor or abscess & ‣ ‣ Head trauma \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
Intracranial hemorrhage & ‣ ‣ Infection \tn 
% Row Count 9 (+ 2)
% Row 5
\SetRowColor{white}
 & ‣ ‣ Tumor \tn 
% Row Count 10 (+ 1)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{COLLABORATION}}  \tn
% Row 0
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\mymulticolumn{2}{x{5.377cm}}{Identify and treat underlying cause} \tn 
% Row Count 1 (+ 1)
% Row 1
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\mymulticolumn{2}{x{5.377cm}}{Control ICP to prevent herniation syndrome} \tn 
% Row Count 2 (+ 1)
% Row 2
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ICP \textgreater{}40 mmHg = life-threatening medical emergency & Diagnosis made on basis of observation, neurologic assessment \tn 
% Row Count 6 (+ 4)
% Row 3
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 & Diagnosis made on basis of observation, neurologic assessment \tn 
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CLINICAL MANIFESTATIONS}}  \tn
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Loss of autoregulation & • ICP continues to rise, cerebral perfusion falls \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
 & • Causes cerebral tissue ischemia, manifestations of cellular hypoxia \tn 
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\mymulticolumn{2}{x{5.377cm}}{} \tn 
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% Row 3
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Changes in cortical function & Earliest manifestations may be delayed by compensatory measures \tn 
% Row Count 10 (+ 3)
% Row 4
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 & • If slow onset of IICP, decrease in level of consciousness (LOC) might not be presenting symptoms Instead visual disturbances, vomiting, or headache \tn 
% Row Count 17 (+ 7)
% Row 5
\SetRowColor{white}
 & • Lumbar puncture could cause brain herniation \tn 
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% Row 6
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 & • {\bf{Cushing triad}} \tn 
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% Row 7
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 & • Behavior, personality changes \tn 
% Row Count 23 (+ 2)
% Row 8
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 & • Impaired memory, judgment \tn 
% Row Count 25 (+ 2)
% Row 9
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 & • Changes in speech pattern \tn 
% Row Count 27 (+ 2)
% Row 10
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 & • LOC decreases to coma, death \tn 
% Row Count 29 (+ 2)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{DX TESTS}}  \tn
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\mymulticolumn{2}{x{5.377cm}}{Diagnosis made on basis of observation, neurologic assessment} \tn 
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% Row 1
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Lumbar puncture not performed when IICP suspected & Release of pressure could cause herniation \tn 
% Row Count 5 (+ 3)
% Row 2
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\mymulticolumn{2}{x{5.377cm}}{Serum osmolality, arterial blood gases (ABGs)} \tn 
% Row Count 6 (+ 1)
% Row 3
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\mymulticolumn{2}{x{5.377cm}}{Electroencephalogram (EEG) may be used to monitor depth of coma or to diagnose brain death} \tn 
% Row Count 8 (+ 2)
% Row 4
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Transcranial Doppler (TCD) to measure cerebral blood flow velocity & Especially for patients who have vasospasms related to cerebral hemorrhage \tn 
% Row Count 12 (+ 4)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{ASESSMENT}}  \tn
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Observation and patient interview & - LOC using GCS \tn 
% Row Count 2 (+ 2)
% Row 1
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 & - Any loss of motor control \tn 
% Row Count 4 (+ 2)
% Row 2
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 & - Primary complaints \tn 
% Row Count 5 (+ 1)
% Row 3
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 & - Events leading up to current condition \tn 
% Row Count 7 (+ 2)
% Row 4
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 & - Basic medical hx \tn 
% Row Count 8 (+ 1)
% Row 5
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Physical examination & - Assessment of neurologic status \tn 
% Row Count 10 (+ 2)
% Row 6
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 & - Pupillary size, reaction to light \tn 
% Row Count 12 (+ 2)
% Row 7
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 & - V/S, incl. temp. \tn 
% Row Count 13 (+ 1)
% Row 8
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Ongoing monitoring & - Assess for, report manifestations of IICP every 15–60 minutes \tn 
% Row Count 17 (+ 4)
% Row 9
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 & - Look for trends \tn 
% Row Count 18 (+ 1)
% Row 10
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 & - Sudden changes may indicate deterioration \tn 
% Row Count 21 (+ 3)
% Row 11
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 & - Subtle change may be early sign of declining neurologic condition \tn 
% Row Count 25 (+ 4)
% Row 12
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\mymulticolumn{2}{x{5.377cm}}{Monitor pulse oximetry, ABGs} \tn 
% Row Count 26 (+ 1)
% Row 13
\SetRowColor{white}
If device to monitor IICP is in place & - Recording readings \tn 
% Row Count 28 (+ 2)
% Row 14
\SetRowColor{LightBackground}
 & - Assess patency of catheter \tn 
% Row Count 30 (+ 2)
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\vfill
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{ASESSMENT (cont)}}  \tn
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 & - Monitor insertion site for s/s of infection \tn 
% Row Count 3 (+ 3)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{NSG DX}}  \tn
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{PLANNING}}  \tn
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{IMPLEMENTATION}}  \tn
% Row 0
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\mymulticolumn{1}{x{5.377cm}}{Ensure adequate oxygenation} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Reduce intracranial pressure} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Reduce environmental stimulation} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Reduce environmental stimulation} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Prepare patient and family for discharge} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{EVALUATION}}  \tn
% Row 0
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Expected outcomes may include & - Patient's ICP returns to acceptable limits following treatment \tn 
% Row Count 4 (+ 4)
% Row 1
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 & - Patient's LOC improves with reduction of ICP \tn 
% Row Count 7 (+ 3)
% Row 2
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 & - Patient experiences no infection as result of ICP monitoring \tn 
% Row Count 11 (+ 4)
% Row 3
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 & - Family describes appropriate outcome expectations \tn 
% Row Count 14 (+ 3)
% Row 4
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 & - Patient and family institute, maintain adequate safety measures after discharge \tn 
% Row Count 19 (+ 5)
% Row 5
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Some patients require days, weeks, or months of monitoring for ICP changes & - Reassess plan of care to be relevant to patient's current condition \tn 
% Row Count 23 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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% That's all folks
\end{multicols*}

\end{document}