FCCS Neurological Assessment Flashcards

What is the recommended head-of-bed elevation in patients with elevated ICP?

Answer: 30 degrees

Elevating the head of bed to 30 degrees facilitates cerebral venous drainage, reducing ICP without significantly compromising cerebral perfusion pressure.

Cerebral perfusion pressure (CPP) is calculated as:

Answer: MAP − ICP

CPP = MAP − ICP; maintaining CPP above 60–70 mmHg ensures adequate cerebral blood flow despite elevated intracranial pressure.

Hypertonic saline and mannitol are used in ICP management primarily because they:

Answer: Create an osmotic gradient to draw fluid out of brain tissue

Both agents increase serum osmolarity, creating an osmotic gradient that draws free water from brain parenchyma across the blood-brain barrier, reducing cerebral edema.

Delirium in ICU patients is best screened using which validated tool?

Answer: Confusion Assessment Method for the ICU (CAM-ICU)

The CAM-ICU is the validated standard tool for detecting delirium in mechanically ventilated ICU patients who cannot verbalize symptoms.

Which intervention is considered first-line for non-pharmacologic delirium prevention in the ICU?

Answer: Early mobilization, sleep hygiene, and reorientation (ABCDEF bundle)

The ABCDEF bundle (Assess, Both SAT/SBT, Choice of analgesia/sedation, Delirium, Early mobility, Family) is the evidence-based framework for delirium prevention.

Neurogenic pulmonary edema following severe TBI or subarachnoid hemorrhage is caused by:

Answer: Massive sympathetic discharge increasing pulmonary capillary pressure

Severe brain injury triggers massive catecholamine release, raising pulmonary vascular pressures and causing fluid transudation into the alveoli.