The physician prescribes intravenous mannitol for a patient who has a head injury and increased intracranial pressure (ICP). Which assessment finding would best indicate to the nurse that the patient is having a therapeutic response to the mannitol?
a. Increased urinary output
b. Decreased Glasgow Coma Scale (GCS) score
c. Increased blood glucose
d. Return of the gag reflex
ANS: A
If ICP remains elevated despite drainage of cerebrospinal fluid, the next step is use of an osmotic diuretic. The most commonly used drug is intravenous mannitol (Osmitrol). Mannitol utilizes osmosis to pull fluid into the intravascular space and eliminate it via the renal system. The GCS score should increase, not decrease. Blood glucose and gag reflex are not affected by mannitol.
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