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Increased Intracranial Pressure

Increase in pressure within the cranium.  Usually caused by trauma, edema and hemorrhaging.

Interventions:

  • * No vagal stimulation with this patient
  • Implement seizure precautions
  • maintain patent airway

Assessment

  • Earliest Sign: decrease in LOC, restlessness and confusion
  • Changes in vital signs (may be a late sign).
  • Systolic blood rises while diastolic pressure remains the same.
  • Elevated Temperature

Nursing Care

  • Maintain fluid balance: fluid restriction of 12-1500 ml. may be ordered.
  • Position client with head of bed elevated 30-45 degrees.
  • Administer Medications as ordered which can include:
  • Hyperosmotic agents (Mannitol, Osmitrol) Corticosteroids (dexamethasone)
  • Diuretics (furosemide, lasix) to reduce cerebral edema
  • Anticonvulsants (phenytoin, Dilantin) to prevent seizures.

The most common symptoms for client with and increased in ICP would include: A blurred vision, changes in cognition and changes in level of consciousness.

  • Patient can also manifest the “Cushing’s Triad) which are vital sign changes that will show a decrease in respirations and pulse rate but increase in BP.

FOR AN INFANT*(SYMPTOMS*

  • bulging fontanels
  • restlessness & irritability
  • high pitched cry

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