Question

The female client admitted to an acute care facility after a car accident develops signs and symptoms of increased intracranial pressure (ICP). The client is intubated and placed on mechanical ventilation to help reduce ICP. To prevent a further rise in ICP caused by suctioning, the nurse anticipates administering which drug endotracheally before suctioning?

a. phenytoin (Dilantin)
b. mannitrol (Osmitrol)
c. lidocaine (Xylocaine)
d. furosemide (Lasix)

Answer 1

c. lidocaine (Xylocaine)

Step-by-step explanation:

Administering lidocaine (Xylocaine) via endotracheal tube may minimize elevations in ICP caused by suctioning. Although mannitol and furosemide may be given to reduce ICP, they're administered parenterally, not endotracheally. Phenytoin does not reduce ICP directly, but may be used to abolish seizures, which can increase ICP. *Phenytoin is not administered endotracheally.

Answer 2

The nurse would likely administer lidocaine (Xylocaine) endotracheally to prevent a further rise in ICP caused by suctioning in an intubated client on mechanical ventilation.

Step-by-step explanation:

To prevent a further rise in intracranial pressure (ICP) caused by suctioning in a client who is intubated and on mechanical ventilation, the nurse anticipates administering lidocaine (Xylocaine) endotracheally before suctioning. Lidocaine is a local anesthetic that can be given via the endotracheal route to numb the tracheal mucosa and minimize the cough reflex during suctioning, which can help prevent spikes in ICP. It is a common practice in critical care to administer lidocaine prior to suctioning to avoid additional brain injury caused by increased ICP.