A patient's mean arterial pressure (MAP) decreases to 50 while his ICP is 20. The nurse realizes that this drop in MAP is likely to lead to:
1. Increased intracranial pressure
2. Hypoxic cerebral tissue
3. Increased urine output
4. Bradycardia
2
Rationale 1: A decline in mean arterial pressure is not going to cause an increase in intracranial pressure.
Rationale 2: Cerebral perfusion is dependent on the blood pressure and the intracranial pressure. It is the difference between the pressure of the incoming blood or MAP and the force opposing perfusion of the brain, or the intracranial pressure. Normal values for cerebral perfusion pressure should be greater than 50 to 60. A pressure less than 40 to 50 usually results in the loss of autoregulation and leads to hypoxia of cerebral tissue.
Rationale 3: A decline in mean arterial pressure is not going to cause an increase in urine output.
Rationale 4: A decline in mean arterial pressure is not going to cause bradycardia.
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