A nurse is caring for a child who has intracranial pressure (ICP) monitoring. The nurse assesses the child and notes that the ICP is 9 mm Hg. Which action by the nurse is most appropriate?
A.
Activate the rapid response team.
B.
Document the finding in the chart.
C.
Hyperventilate the patient.
D.
Prepare to administer mannitol (Osmotrol).
ANS: B
A normal ICP is 0-10 mm Hg. This finding is normal and the nurse needs only to document it and continue monitoring. No other actions are needed.
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