The nurse is planning care for a patient who had a supratentoral craniotomy. What will be included in this plan of care?
1. Apply a soft cervical collar.
2. Keep the head of the bed elevated at a 30-degree angle.
3. Keep the head of the bed flat.
4. Position the patient on the side of the tumor.
2
Rationale 1: This patient had surgery involving the supretetorium; therefore, a cervical collar is not necessary.
Rationale 2: Post-operatively, patients are usually positioned with the head of their bed elevated 30 degrees. This facilitates venous drainage from the head and neck, preventing increases in intracranial pressure and increasing patient comfort.
Rationale 3: The head of the bed needs to be elevated at least 10 degrees or greater up to 60 degrees in order to facilitate venous drainage from the operative site. This prevents increased intracranial pressure and herniation.
Rationale 4: This patient had a small tumor resected. If a large tumor was resected, the patient would usually not be permitted to turn the head to the operative side because it may cause a shift in cerebral contents.
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