Page 2553 - Saunders Comprehensive Review For NCLEX-RN

▪ The surgeon may prescribe that the head of the bed be elevated at 30 degrees to
promote venous outflow through the jugular veins.
▪ Do not lower the head of the bed in the acute phase of care following surgery
without a surgeon’s prescription.

Box 69-21
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▪ Clients must be withdrawn slowly from corticosteroid therapy to reduce the risk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; an infusion pump is always used to
control the amount administered.
▪ Infusions are monitored closely because of the risk of promoting additional

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