- Sensory Stimulation and Communication
- Talk to and touch patient and encourage family to talk to and touch the patient
- Maintain normal day night pattern of activity
- Orient the patient frequently
- Note: When arousing from coma, a patient may experience a period of agitation;
minimize stimulation at this time
- Programs for sensory stimulation
- Allow family to ventilate and provide support
- Reinforce and provide and consistent information to family
- Referral to support groups and services for family
Increased Intracranial Pressure- Monro-Kellie hypothesis: because of limited space in the skull, an increase in any one
of components of the skull—brain tissue, blood, and CSF—will cause a change in the
volume of the others
- Compensation to maintain a normal ICP of 10–20 mm Hg is normally accomplished
by shifting or displacing CSF
- Elevated ICP is most commonly associated with head injury, it also may be seen as a
secondary effect in other conditions, such as brain tumors, subarachnoid hemorrhage,
and toxic and viral encephalopathies
- Increased ICP decreases cerebral perfusion and causes ischemia, cell death, and
(further) edema
- Brain tissues may shift through the dura and result in herniation
- CO2 plays a role; decreased CO2 results in vasoconstriction, increased CO2 results in
vasodilatation
Manifestations of Increased ICP: Early
- Changes in LOC
- Any change in condition
- Restlessness, confusion, increasing drowsiness, increased respiratory effort,
purposeless movements
- Restlessness, confusion, increasing drowsiness, increased respiratory effort,