The nurse is caring for a neonate with an intraventricular hemorrhage. What interventions should the nurse avoid to prevent any increase in intracranial pressure? (Select all that apply.)
a. Keeping the head of the bed flat
b. Keeping the environment quiet
c. Handling the neonate minimally
d. Suctioning the endotracheal tube frequently
e. Maintaining the neonate's head in a midline position
ANS: A, D
Some nursing procedures increase intracranial pressure (ICP). For example, blood pressure increases significantly during endotracheal suctioning in preterm infants, and head positioning produces measurable changes in ICP. ICP is highest when infants are in the dependent (flat) position and decreases when the head is in a midline position and elevated 30 degrees. Keeping the environment quiet, handling the neonate minimally, and maintaining the neonate's head in a midline position are measures to keep the ICP down.
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