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Nursing QUESTION #9235
Question 1
In Increased Intracranial Pressure (ICP) management, a patient's ICP is \(22 \text{ mmHg}\) and MAP is \(90 \text{ mmHg}\). What is the Cerebral Perfusion Pressure (CPP) and is it adequate?
  • \(\text{CPP} = 68 \text{ mmHg}\) — adequate (target \(\geq 60 \text{ mmHg}\))✔️
  • \(\text{CPP} = 112 \text{ mmHg}\) — dangerously high
  • \(\text{CPP} = 45 \text{ mmHg}\) — inadequate, cerebral ischemia likely
  • \(\text{CPP} = 58 \text{ mmHg}\) — borderline, immediate intervention needed
Correct Answer Explanation
Correct Answer: A — CPP = 68 mmHg, adequate

Formula:
\[\text{CPP} = \text{MAP} - \text{ICP}\]
\[\text{CPP} = 90 - 22 = 68 \text{ mmHg}\]

Target values in TBI management (Brain Trauma Foundation):
  • CPP target: \(60 - 70 \text{ mmHg}\)
  • ICP target: \(< 20 \text{ mmHg}\)
  • MAP target: \(\geq 80 \text{ mmHg}\)
ICP management interventions:
  • Head of bed elevation \(30°\)
  • Hyperosmolar therapy: Mannitol \(0.25 - 1 \text{ g/kg}\) IV or hypertonic saline (3%)
  • Controlled hyperventilation: target \(\text{PaCO}_2 = 35 \text{ mmHg}\) (temporary)
  • Sedation and analgesia
  • Avoid hyperthermia, hypoxia, hypotension
  • CSF drainage via ventriculostomy