When administering mannitol (Osmitrol) to a patient with increased intracranial pressure (ICP), the nurse would:
1. Expect that any reduction in ICP will begin approximately an hour after the dose is administered.
2. Assess the patient carefully for the development of hypertension.
3. Review lab data to identify the presence of hypernatremia and hyperkalemia.
4. Monitor the osmolality of the blood every 4 to 6 hours if repeated doses are administered.
4
Rationale 1: The reduction in intracranial pressure would begin almost immediately.
Rationale 2: Mannitol can cause hypotension.
Rationale 3: Hyponatremia and hypokalemia can occur with this medication.
Rationale 4: Mannitol increases the osmolality of the blood with optimal osmolality between 300 and 320 mOsm. If repeated doses of mannitol are given, the nurse monitors the serum osmolality every 4 to 6 hours and ensures that it remains less than 320 mOsm.
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