A patient is admitted with a traumatic brain injury. To prevent the onset of a secondary brain injury, level two interventions would be focused to do which of the following?
1. prevent constriction of venous outflow from the brain
2. reduce metabolism
3. reduce intracranial pressure and optimize cerebral perfusion pressure
4. reduce refractory intracranial hypertension
3
Rationale: Level two interventions are focused on reducing elevated intracranial pressure, optimizing cerebral perfusion pressure, and preventing secondary injury. First level interventions are those that would prevent constriction of venous outflow from the brain. Level three interventions include those that would reduce metabolism as seen with hypothermia. Level four interventions are those that focus on the treatment of severe, refractory intracranial hypertension that does not respond to conventional therapeutic measures.
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