Question

A nurse is caring for a client who had a stroke 6 hr ago. Which of the following interventions should the nurse implement to reduce the risk of increased ICP?

a) Elevate the head of the bed
b) Encourage coughing and deep breathing exercises
c) Administer a hypertonic saline solution
d) Keep the room warm and dimly lit

Answer 1

To reduce the risk of increased ICP in a stroke patient, the nurse should implement the intervention of elevating the head of the bed.

Step-by-step explanation:

To reduce the risk of increased ICP (intracranial pressure) in a stroke patient, the nurse should implement the intervention of elevating the head of the bed. This position helps to promote venous drainage from the head and reduce cerebral edema, thus decreasing ICP.

Encouraging coughing and deep breathing exercises can be beneficial in preventing respiratory complications and maintaining adequate oxygenation, but it does not directly reduce ICP. Administering a hypertonic saline solution may be used in certain cases to reduce cerebral edema, but it is not a general intervention for all stroke patients. Keeping the room warm and dimly lit is not specific to reducing ICP in stroke patients.