Question

A patient who sustained a head injury in a motorcycle crash has a baseline Glasgow Coma Scale (GCS) score of 14. The nurse recognizes signs of increasing intracranial pressure on the basis of what assessment findings?

-Increased systolic blood pressure, increased pulse, GCS score of 12

-Decreased diastolic blood pressure, decreased pulse, and GCS score of 13

-Increased systolic and diastolic blood pressure, increased pulse, GCS score of 9

-Increased systolic blood pressure, decreased pulse, widening pulse pressure, GCS score of 4

Answer 1

The nurse recognizes signs of increasing intracranial pressure in a patient with a head injury by observing increased systolic blood pressure, decreased pulse, widening pulse pressure, and a decrease in the Glasgow Coma Scale (GCS) score.

Step-by-step explanation:

The nurse recognizes signs of increasing intracranial pressure in a patient who sustained a head injury in a motorcycle crash by observing the following assessment findings:

• Increased systolic blood pressure: Elevated systolic blood pressure may indicate the body's compensatory response to maintain cerebral perfusion despite increased intracranial pressure.
• Decreased pulse: A slow pulse may be a sign of increased intracranial pressure as the body tries to divert blood away from the brain to reduce pressure.
• Widening pulse pressure: Pulse pressure is the difference between systolic and diastolic blood pressure. A widening pulse pressure may occur when the systolic blood pressure increases due to increased intracranial pressure.
• GCS score of 4: Glasgow Coma Scale (GCS) assesses the level of consciousness in a patient. A decrease in GCS score indicates worsening neurological status and may be a sign of increasing intracranial pressure.