07.04 Supratentorial Herniation and Glasgow Coma Scale

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Included In This Lesson

Outline

Nursing Points

General

  1. Supratentorial herniation
    1. Brain shifts down within the skull
    2. Symptoms include a change in LOC
      1. Assessed with the Glasgow Coma Scale
        1. Score based on level of response
          1. Max score is 15, minimum score is 3
            1. Eye Opening
              1. Spontaneous (4)
              2. To verbal (3)
              3. To pain (2)
              4. None (1)
            2. Verbal Response
              1. Oriented (5)
              2. Confused (4)
              3. Inappropriate (3)
              4. Incomprehensible (2)
              5. None (1)
            3. Motor
              1. Obeys commands (6)
              2. Purposeful movement with pain stimuli – has to cross midline (5)
              3. Withdraws with painful stimuli (4)
              4. Flexion in response to painful stimuli (decorticate) (3)
              5. Extension in response to painful stimuli (decerebrate) (2)
              6. None (1)
        2. For supratentorial herniation, pay attention to the eyes
          1. Eyes
            1. Pupils dilate in supratentorial herniation
      2.  Hyperventilation occurs
          1. Causes alkalosis
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CCRN Review (Critical Care Certification Review)

Course Description
Module 1- CCRN Test Overview & Introduction

01.01 CCRN Test Overview
Module 2- Cardiovascular

02.01 Hypertensive Crisis

02.02 Cardiomyopathy

02.03 Swan-Ganz Catheters

02.04 Pulmonary Artery Wedge Pressure (PAWP)

02.05 Calculating PAWP on PEEP

02.06 Heart Murmurs

02.07 Reading “A, C, V Waves” & PAWP Waveforms

02.08 Cardiac Catheterization & Acute Coronary Syndrome

02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF

02.10 12 Lead EKG- Lead V1-V6

02.11 12 Lead EKG- Injuries

02.12 Myocardial Infarction- Inferior Wall

02.13 Myocardial Infarction – Anterior Septal Wall

02.14 Shock Stages

02.15 Hypovolemic Shock

02.16 Cardiogenic Shock

02.17 Septic Shock

02.18 Cardiovascular Practice Questions for CCRN
Module 3- Endocrine

03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH)

03.02 Diabetes Insipidus

03.03 Hypoglycemia
  • Questions: 9

03.04 DKA vs HHNK

03.05 Endocrine Practice Questions
Module 4- Hematology

04.01 Hematology for the CCRN

04.02 Hematology Review Questions for CCRN
Module 5- Gastrointestinal

05.01 Pancreatitis and Large Bowel Obstruction

05.02 Liver Overview and Disease

05.03 Jaundice

05.04 Ruptured Spleen

05.05 GI Practice Questions
Module 6- Multisystem

06.01 Organ Failure, Dysfunction & Trauma

06.02 Poisoning

06.03 Multi-System CCRN Important Points

06.04 Differentiating Ectopy and Aberrancy

06.05 Wide Complex Tachycardia
Module 7- Neurological

07.01 CVA (Cerebrovascular Accident/Stroke)

07.02 Neuro Anatomy

07.03 Uncal Herniation

07.04 Supratentorial Herniation and Glasgow Coma Scale

07.05 Supratentorial Herniation: Cushings Triad

07.06 Increased Intracranial Pressure (ICP)

07.07 Cerebral Perfusion Pressure

07.08 Basilar Skull Fracture

07.09 Meningitis

07.10 Neurologic Review questions
Module 8- Psychological

08.01 Psychological Review for the CCRN
Module 9- Renal

09.01 Acute Renal Failure Overview

09.02 Acute Tubular Necrosis

09.03 Acute Renal (Pre-Renal vs Renal) Failure

09.04 Continuous Renal Replacement Therapy

09.05 Chronic Renal Failure

09.06 Renal Practice Questions for CCRN
Module 10- Pulmonary

10.01 Arterial Blood Gas (ABG) Interpretation

10.02 Breath Sounds

10.03 Acute Respiratory Failure

10.04 Pulmonary Question Review