The client is in the hospital with increased intracranial pressure (IICP). The nurse should question ...

The answer to question 1

Answer: 2

1. Mannitol is an osmotic diuretic and is appropriate for a client with IICP.
2. 10 dextrose can cross the blood-brain barrier and cause rising pressures.
3. Lactated Ringer's is a solution that does not cross the blood-brain barrier and is appropriate for the client with IICP.
4. Loop diuretics are appropriate for the client with IICP.

The answer to question 2

Answer: 3

1. A burr hole is a hole drilled into the scalp to relieve pressure or remove a clot.
2. A craniotomy is surgery to remove a part of the skull to remove a tumor, and the flap is replaced in the same surgery.
3. Cranioplasty is surgery that inserts a metal plate or other material to take the place of the bone flap that was previously removed.
4. Craniectomy is the removal of a bone flap to provide relief from pressure.

The answer to question 3

Answer: 1

1. Lumbar puncture is performed to culture the cerebrospinal fluid, and fluid pressure can be measured as well during this procedure.
2. There is no preparation for a CBC.
3. The head is not x-rayed for infection or to view internal problems, because the x-ray cannot penetrate bone.
4. There is no Doppler study of the head.

The answer to question 4

Answer: 2

1. Lumbar surgery is not performed to relieve pressure.
2. A part of the bone is removed from the skull, decreasing pressure by allowing for expansion of the brain, and is called a bone flap.
3. Carotid artery surgery is performed to clear those arteries and restore blood flow to the brain.
4. A drain can be placed to relieve pressure and provide drainage, but it is placed in the skull, not the ear.

The answer to question 5

Answer: 2

1. The physician might order a CBC and serum electrolytes.
2. A CT scan is done to discover the presence of a tumor.
3. An EEG is done to detect seizures.
4. A Doppler ultrasound of the carotid views the flow of blood to the brain.

The answer to question 6

Answer: 4

1. Disorientation implies that the client is conscious, which this client is not.
2. Early IICP is characterized by irritability, blurred vision, increased heart rate, and headache.
3. A subdural hematoma has the manifestations of headache, drowsiness, slowed thinking, and confusion, with possible ipsilateral pupil dilation.
4. The client is in late IICP, which is a medical emergency.

Amazing, correctly answered