A nurse is admitting a patient with a subarachnoid hemorrhage and expects to administer which of the following medications to decrease intracranial pressure (ICP)?

Choice A rationale
Rebleeding of the injury is a significant factor related to a high mortality rate for a client who has a subarachnoid hemorrhage (SAH). SAH is a devastating event with substantial mortality and high morbidity among survivors. The most common primary causes of death or neurological devastation leading to withdrawal of support are direct effects of the primary hemorrhage (55%) and aneurysm rebleeding (17%)2. Therefore, rebleeding of the injury is a critical concern in the management of SAH.
Choice B rationale
Decreased cerebrospinal fluid is not directly linked to a high mortality rate in SAH. While changes in cerebrospinal fluid dynamics can occur after SAH, it’s not typically a primary factor contributing to mortality.
Choice C rationale
The use of nimodipine is actually part of the treatment protocol for SAH. Nimodipine is a calcium channel blocker that is used to prevent cerebral vasospasm, a complication of SAH. It does not contribute to a higher mortality rate.
Choice D rationale
Poor functional ability could be a result of SAH due to neurological damage, but it is not a direct cause of high mortality. The severity of the initial hemorrhage and subsequent

complications like rebleeding or medical complications are more directly tied to mortality rates.

Choice A rationale
Osmotic cerebral edema is a condition where water moves from the blood vessels into the brain due to changes in the concentration of particles in the blood. However, this is not the primary cause of cerebral edema in meningitis.
Choice B rationale

While inflammation can contribute to cerebral edema, it is not specific to the brain and does not affect the brain the most. In meningitis, the inflammation is primarily in the meninges, the membranes that cover the brain, and not the whole body.
Choice C rationale
Cerebrospinal fluid (CSF) does flow from the intraventricular space to the interstitial area of the brain, but this is a normal process and does not cause cerebral edema. In meningitis, the inflammation of the meninges can disrupt the normal flow and absorption of CSF, leading to an accumulation of fluid and increased intracranial pressure.
Choice D rationale
In meningitis, the inflammation and immune response to the infection can lead to an increase in the permeability of the blood-brain barrier. This allows fluid and immune cells to enter the brain tissue, leading to cerebral edema. Additionally, the by-products of the pathogen that causes meningitis can directly damage the brain tissue and contribute to the edema.