A patient's ICP is 34 mm Hg, and his cerebral perfusion pressure is 65 mm Hg. Which of the following is the most appropriate intervention?
a. These are normal values, and no interventions are required.
b. Administer mannitol 1 to 2 g/kg IV.
c. Have the patient lie flat in bed.
d. Suction the patient to see if improving his airway will help his ICP.
B
Mannitol is an osmotic diuretic and will pull swelling out of edematous brain tissue, thereby decreasing intracranial pressure (ICP). Having the patient lie flat in bed will impair venous drainage from the head and worsen ICP. Suctioning will cause increased intrathoracic pressure, which will also worsen the already elevated ICP.
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