NEUROLOGY
SURGERY
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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The nurse is caring for a patient postoperatively after intracranial surgery for the treatment of a subdural hematoma. The nurse observes an increase in the patient’s blood pressure from the baseline and a decrease in the heart rate from 86 to 54, and crackles in the bases of the lungs. Which situation does the nurse suspect is occurring?
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Increased ICP
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Exacerbation of uncontrolled hypertension
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Infection
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Increase in cerebral perfusion pressure
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Explanation:
Detailed explanation-1: -Activities that can increase ICP should be avoided. These activities include suctioning, coughing, vomiting, and compression of jugular veins. Patient care should not be clustered, as this may also cause an increase in ICP. A ventriculostomy can be used to continuously monitor a patient’s intracranial pressure.
Detailed explanation-2: -It is normally 7-15 mm Hg in adults who are supine, with pressures over 20 mm Hg considered pathological and pressures over 15 mm Hg considered abnormal. Note that ICP is positional, with elevation of the head resulting in lower values. A standing adult generally has an ICP of-10 mm Hg but never less than-15 mm Hg.
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