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Interventions for Patients with Increasing Intracranial Pressure 🧠

By Amber Gochoel, @sparklyscrubs

#TeamUrbane member, Amber (@sparklyscrubs), discusses the signs patients express when experiencing increasing intracranial pressure, and interventions to implement if you detect it early!

Find her on Instagram for more tips + accompany her on her journey starting nursing residency and becoming a NICU nurse.


This is a topic area we are currently being tested on, so I thought it would be fun to review together!

These patients’ futures hinge on us identifying signs of ICP and implementing our nursing interventions.

Early signs: lethargy, restlessness, LOC changes

Later signs: vomiting, headaches, seizures, positive Babinski reflex, irregular breathing such as Cheyne-stokes, bradycardia, hypertension, increasing distance between systolic and diastolic numbers

Interventions to implement:

  • HOB up to 30 degrees

  • Look for CSF drainage from the nose or ears

  • Avoid clustering care, instead, give plenty of time for rest

  • Frequent neuro assessments

  • Dim lights and have the patient avoid screen time (tv, iPad, phone)

  • Avoid mentally strenuous activities like reading difficult books, solving puzzles, etc

  • Maintain a normal body temperature as both fever and shivering can affect ICP

  • Give mannitol

  • Utilize the Glasgow coma scale

  • Have the patient avoid straining activities like sneezing, coughing, vomiting, and bearing down

A version of this blog first appeared on Amber's Instagram, @sparklyscrubs. It is reproduced here with the permission of the author. Information was sourced from Focus on Adult Health Med Surgical Nursing by Linda Honan.

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