Why Should Critical Care Nurses Measure The Percent Change In Pupil Size?
The pupil exam is one of the most commonly used tests in critical care nursing to assess a critical care patient's neurological status and responsiveness. The size and reaction of the pupil will affect how much light reaches the retina, influencing sensory stimulation. A difference in percent change may determine an existing deficit or detect an impending problem. Studying this information from each patient can help health professionals better understand the patients and provide useful benchmarking data for improved patient care.
1. Assess the severity of the head injury The most important reason is to assess the severity of the head injury. When there is a head injury, one of the first things you should notice is whether the pupils are dilated. If they are, you know that there has been some sort of trauma to the brain and need to be more concerned about your patient's condition than if his pupils were not dilated.
In addition, you should also note that if their pupils do not react right away after being exposed to light (they stay fixed), they may have also suffered brain damage.
2. Assess the increase or decrease in intracranial pressure The second reason for measuring pupil size is to help assess intracranial pressure.
When a patient is experiencing an increase in intracranial pressure, the brain will push against the skull and compress the optic nerve, which results in constriction of the pupils. When a person's intracranial pressure decreases, there will be less compression on the optic nerve and, thus, dilated pupils. Therefore, it's important to measure changes in pupil size.
3. Assess changes in the level of consciousness The clinician must assess the patient's level of consciousness. The Glasgow Coma Scale (GCS) and a pupilometer are useful to quantify this.
4. Assess the patient's response to pain, light, or other stimuli Critical care nurses should measure the percent change in pupil size to assess the patient's response to pain, light, or other stimuli.
Besides monitoring the patient's vital signs, critical care nurses need to assess the patient's response to pain, light, or other stimuli. The pupils are a good indicator of how well a person responds to stimuli.
5. Assess Pupillary Light Reflex (PLR) abnormality For several reasons, a critical care nurse must measure the percent change in pupil size. Besides assessing pupil size, you can also evaluate the ability of the patient's pupils to dilate in response to light. This is called the pupillary light reflex (PLR). It is essential because it can indicate brainstem damage.