Page 2042 - Saunders Comprehensive Review For NCLEX-RN
P. 2042

▪ Use splints to prevent wrist deformities.

                  ▪ Initiate physical therapy as appropriate.



               Box 58-7

               Medications for Increased Intracranial Pressure

               Antiseizure


                  ▪ Seizures increase metabolic requirements and cerebral blood flow and volume,
                    thus increasing intracranial pressure (ICP).
                  ▪ Medications may be given prophylactically to prevent seizures.


               Antipyretics and Muscle Relaxants


                  ▪ Temperature reduction decreases metabolism, cerebral blood flow, and thus ICP.
                  ▪ Antipyretics prevent temperature elevations.
                  ▪ Muscle relaxants prevent shivering.


               Blood Pressure Medication


                  ▪ Blood pressure medication may be required to maintain cerebral perfusion at a
                    normal level.
                  ▪ Notify the primary health care provider if the blood pressure range is lower than
                    100 or higher than 150 mm Hg systolic.


               Corticosteroids


                  ▪ Corticosteroids stabilize the cell membrane and reduce leakiness of the blood-
                    brain barrier.
                  ▪ Corticosteroids decrease cerebral edema.
                  ▪ A histamine blocker may be administered to counteract the excess gastric
                    secretion that occurs with the corticosteroid.
                  ▪ Clients must be withdrawn slowly from corticosteroid therapy to reduce the risk
                    of adrenal crisis.


               Intravenous Fluids


                  ▪ Fluids are administered intravenously via an infusion pump to control the
                    amount administered.
                  ▪ Infusions are monitored closely because of the risk of promoting additional
                    cerebral edema and fluid overload.





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