Which of the following procedure or activities can cause an ...

[CORALGRILL2014]

Which of the following procedure or activities can cause an increased intracranial pressure? I. obtaining an arterial blood sample from an arterial line II. increasing the delivered Fio2 III. endotracheal suctioning IV. airway manipulation
 
  A. I, IV only
  B. III, IV only
  C. I, III, IV only
  D. II, III, IV only

Question 2

In which of the following orientations should a patient with TBI be positioned?
 
  A. positioned with head elevated 30 degrees
  B. supine position
  C. prone position
  D. Fowler's position

[flannelavenger]

Answer to Question 1

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Positive-pressure ventilation can have a detrimental effect on the CPP if the ventilatory strategies lead to either a rise in ICP or a drop in MAP. Performing endotracheal suctioning, coughing, and manipulating airway pressure can induce a rise in ICP. Positive-pressure ventilation and PEEP tend to decrease venous return to the right ventricle, which can lead to a decrease in the MAP.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.

Answer to Question 2

ANS: A
A. Correct response: As with all mechanically ventilated patients, the head of the bed should be maintained at an elevation of 30 degrees, not only to minimize aspiration, but also to facilitate venous drainage in this patient population. Other measures used to avoid venous congestion include keeping a midline head position, avoidance of internal jugular catheters if possible, and ensuring that cervical collars, if present, are not too constrictive.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A

[CORALGRILL2014]

Excellent

[ghepp]

TYSM