The primary care provider states that the patient is experiencing ...

[natalie2426]

The primary care provider states that the patient is experiencing vasogenic edema. The nurse real-izes vasogenic edema is clinically important because:
 
  a. it usually has an infectious cause.
  b. the blood-brain barrier is disrupted.
  c. ICP is excessively high.
  d. it always causes herniation.

Question 2

The progress notes read: the cerebellar tonsil has shifted through the foramen magnum due to in-creased pressure within the posterior fossa. The nurse would identify this note as a description of _____ herniation.
 
  a. supratentorial
  b. central
  c. cingulated gyrus
  d. infratentorial

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Answer to Question 1

ANS: B
Vasogenic edema is clinically important because the blood-brain barrier (selective permeability of brain capillaries) is disrupted, and plasma proteins leak into the extracellular spaces. Vasogenic edema does not have an infectious cause. ICP is increased, but not more so than other forms of edema. Vasogenic edema does not always cause herniation.

Answer to Question 2

ANS: D
In infratentorial herniation, the cerebellar tonsil shifts through the foramen magnum because of increased pressure within the posterior fossa. Supratentorial herniation involves temporal lobe and hippocampal gyrus shifting from the middle fossa to posterior fossa. Central herniation is a type of supratentorial herniation and is the straight downward shift of the diencephalon through the tentorial notch. Gyrus herniation occurs when the cingulate gyrus shifts under the falx cerebri. Little is known about its clinical manifestations.