Which nursing interventions will help prevent sharp spikes in ICP ...

[Alainaaa8]

Which nursing interventions will help prevent sharp spikes in ICP and surgical hemorrhage?
 
  a. Keep the head of the bed elevated 45 to 90 degrees.
  b. Administer an antiemetic to prevent vomiting.
  c. Provide fluid restriction.
  d. Help with turn, cough, and deep breathe exercises.

Question 2

Studies have shown that the intraparenchymal catheter has a better result than the intraventricular catheter. Identify the answer that supports this statement.
 
  a. The intraparenchymal catheter allows for CSF drainage.
  b. The intraparenchymal catheter has increased monitoring time.
  c. The intraparenchymal catheter has a longer insertion time for monitoring ICP.
  d. The intraparenchymal catheter has decreased device-related complications.

[mcni194]

Answer to Question 1

B
Postoperative vomiting must be avoided to prevent sharp spikes in intracranial pressure (ICP) and possibly surgical hemorrhage. Antiemetics are administered as soon as nausea is apparent. Fluid restriction may be ordered as a routine measure to lessen the severity of cerebral edema or as treatment for the fluid and electrolyte imbalances associated with the syndrome of inappropriate antidiuretic hormone secretion. Most craniotomy patients can be turned from side to side within these restrictions, using pillows for support, except in some cases of extensive tumor removal, cranioplasty, and when the bone flap is not replaced. Routine pulmonary care is used to maintain airway clearance and prevent pulmonary complications. To prevent dangerous elevations in ICP, this care measure must be performed using proper technique and at time intervals that are adequately spaced from other patient care activities.

Answer to Question 2

D
The intraventricular space is considered the gold standard for monitoring of intracranial pressure because it is the most accurate of all methods. However, a recent study found that an intraparenchymal catheter was better than an intraventricular catheter unless cerebrospinal fluid drainage was required. The intraparenchymal catheter was associated with decreased monitoring time, decreased length of stay, and decreased device-related complications.