Icu Reflection Paper

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Reflection 1: Plan of Care This reflection paper is compiled on the care of a patient that was admitted to Providence Holy Cross Medical Center with a diagnosis of a severe traumatic brain injury, pulmonary contusion, respiratory failure, and multiple fractures of the extremities. Due to the severity of the trauma, the patient was closely monitored in the ICU on 3/2/15. In this reflection paper, I will focus on the pathophysiology, signs and symptoms, treatments, interventions, and evaluations of care regarding the diagnosis of severe traumatic brain injury for the patient, JL, and compare and contrast the care to the textbook reading for similarities or differences. A traumatic brain injury can occur due to either a blow or jolt to…show more content…
The cranial contents include brain tissue, blood, and cerebrospinal fluid (CSF) these components are encased in the relatively rigid skull. There is little room for any of the components to expand or increase in volume, and with accommodation and compliance a normal level between 10-15 mm Hg is maintained (Ignatavicius, 2013). During the stay in the ICU, we had to keep the ICP below 20 mm Hg because as the ICP increases cerebral perfusion decreases, leading to tissue hypoxia, a decrease in serum pH level, and an increase in the level of carbon dioxide. This process causes cerebral vasodilation, edema, and further increasing the ICP, which could eventually lead to brain herniation. (Ignatavicius, 2013). Another top priority was to continually monitor the patient’s CCP number, which is the cerebral perfusion pressure. The CPP can be calculated by subtracting the ICP number from the mean arterial pressure (MAP), and this number should be maintained above seventy for the most optimal outcome. The CPP is the pressure gradient over which the brain is perfused. It is influenced by oxygenation, cerebral blood volume, blood pressure, and cerebral edema (Ignatavicius, 2013). After a brain injury the homeostatic mechanisms that help auto-regulate blood flow are lost, causing an increase in vascular resistance making
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