Question

A nurse is caring for a client 1 day postoperative craniotomy. Which nursing actions are appropriate to prevent increased intracranial pressure? Select all that apply.

Answer 1

Nursing actions appropriate to prevent increased intracranial pressure after craniotomy include elevating the head of the bed, monitoring vital signs and neurological status, administering ICP-lowering medications, maintaining a calm environment, minimizing suctioning, and avoiding patient straining.

Step-by-step explanation:

The care of a patient one day after craniotomy is crucial in preventing increased intracranial pressure (ICP). There are several nursing actions that can be appropriate in this situation:

• Maintain the head of the bed at 30 to 45 degrees unless contraindicated, to promote venous drainage from the brain.
• Monitor vital signs and neurological status frequently, according to the surgeon's guidelines, to quickly identify changes in ICP.
• Administer medications, like mannitol or hypertonic saline if prescribed, that reduce ICP by decreasing cerebrospinal fluid volume or edema.
• Provide a calm and quiet environment to minimize stress and avoid stimuli that can increase ICP like pain or agitation.
• Limit suctioning and other nursing interventions that can transiently increase ICP.
• Ensure that the patient avoids straining during bowel movements, as this can increase ICP.

Each of these nursing actions helps maintain stable ICP and facilitate brain perfusion, thus aiding recovery post craniotomy.

Cooperation among the surgical team, including the surgeon, nurse, and anesthesia professional, is imperative for successful patient care. The functions of cerebrospinal fluid such as mechanical protection and prevention of brain ischemia are essential considerations in postoperative care.