Author Question: The unconscious patient with a closed head injury is on mechanical ventilation. To improve brain ... (Read 32 times)

jilianpiloj · **on:** Jun 25, 2018

The unconscious patient with a closed head injury is on mechanical ventilation. To improve brain perfusion through increased blood pressure, the carbon dioxide (CO2) should be maintained at what level?

a. 10 to 15 mm Hg
b. 15 to 20 mm Hg
c. 20 to 25 mm Hg
d. 25 to 30 mm Hg

Question 2

Following a craniotomy to relieve increased intracranial pressure (ICP), which implementation should the nurse implement?

a. Elevate the head of the bed 20 to 30 de-grees.
b. Place drip pad or cotton to absorb cere-brospinal fluid (CSF) drainage from the nose or ears.
c. Stimulate the patient to better assess changing level of consciousness (LOC).
d. Reposition the patient frequently for comfort.

TheNamesImani · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

D
The CO2 level is set to be maintained at 25 to 30 mm Hg to create vascular constriction, raise blood pressure, and perfuse the cerebrum.

Answer to Question 2

A
A patent airway must be secured, and the head raised 20 to 30 degrees with the body in correct alignment. Elevation helps reduce ICP. Neurologic signs are monitored closely. An IV line is inserted for access for diuretic drugs, if needed, and for administration of fluid. IV fluids are infused very slowly to prevent fluid overload that would increase the ICP. Diuretics are used to decrease vascular volume and keep ICP as low as possible. Drip pads, patient stimulation, and changing positions frequently may increase ICP.