The nurse caring for a patient with increased intracranial pressure (ICP) would be correct in assessing for which of the following early clinical manifestations?

A) Disorientation and restlessness
B) Decreased pulse and respirations
C) Projectile vomiting
D) Loss of corneal reflex


Ans: A
Feedback: Early indicators of ICP include disorientation and restlessness. Later signs include decreased pulse and respirations, projectile vomiting, and loss of brain stem reflexes, such as the corneal reflex.

Nursing

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