The nurse is caring for a patient with increased intracranial pressure (ICP) caused by a traumatic brain injury
Which of the following clinical manifestations would suggest that the patient may be experiencing increased brain compression causing brain stem damage?
A) Hyperthermia
B) Tachycardia
C) Hypertension
D) Bradypnea
Ans: A
Feedback:
Signs of increasing ICP include slowing of the heart rate (bradycardia), increasing systolic BP, and widening pulse pressure. As brain compression increases, respirations become rapid, BP may decrease, and the pulse slows further. A rapid rise in body temperature is regarded as unfavorable. Hyperthermia increases the metabolic demands of the brain and may indicate brain stem damage.
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