A patient with increased intracranial pressure (ICP) has a diagnosis of ineffective cerebral tissue perfusion. An expected outcome the nurse would document for this diagnosis would include which of the following?
A) Copes with sensory deprivation
B) Registers normal body temperature
C) Pays attention to grooming
D) Obeys commands with appropriate motor responses
Ans: D
Feedback: An expected outcome of the ineffective tissue perfusion diagnosis in a patient with ICP includes obeying commands with appropriate motor responses. Vitals signs and neurologic status are assessed every 15 minutes to 1 hour. Coping with sensory deprivation relates to the nursing diagnosis of disturbed sensory perception. Normal body temperature relates to the diagnosis of potential for ineffective thermoregulation. Paying attention to grooming relates to the diagnosis of body image disturbance.
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