A nurse is caring for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. Which of the following medications should the nurse plan to administer?

Dextran 70

Hydroxyethyl starch

Albumin 25%

Mannitol 25%

Answer and Explanation

The Correct Answer is D

Choice A Reason: Dextran 70 is not a medication that the nurse should plan to administer for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. Dextran 70 is a plasma expander that increases the blood volume and viscosity, which can worsen the intracranial pressure by increasing the cerebral blood ﬂow and edema.

Choice B Reason: Hydroxyethyl starch is not a medication that the nurse should plan to administer for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. Hydroxyethyl starch is another plasma expander that has similar eﬀects as dextran 70, and can also increase the risk of coagulopathy and renal failure.

Choice C Reason: Albumin 25% is not a medication that the nurse should plan to administer for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. Albumin 25% is a colloid solution that increases the oncotic pressure and draws ﬂuid from the interstitial space into the intravascular space, which can also worsen the intracranial pressure by increasing the cerebral blood ﬂow and edema.

Choice D Reason: Mannitol 25% is a medication that the nurse should plan to administer for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. Mannitol 25% is an osmotic diuretic that reduces the intracranial pressure by creating an osmotic gradient and drawing ﬂuid from the brain tissue into the blood vessels, which can then be excreted by the kidneys. The nurse should monitor the urine output, serum osmolality, and electrolytes when administering mannitol 25%.

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Correct Answer is D

Explanation

Choice A Reason: This choice is incorrect because warm, ﬂushed skin is not a sign of respiratory acidosis. Warm, ﬂushed skin may indicate fever, infection, inﬂammation, or allergic reaction, but it does not reﬂect the acid-base imbalance in the blood.

Choice B Reason: This choice is incorrect because hyperactive deep tendon reﬂexes are not a sign of respiratory acidosis. Hyperactive deep tendon reﬂexes may indicate hypocalcemia, hyperthyroidism, or spinal cord injury, but they do not reﬂect the carbon dioxide level in the blood.

Choice C Reason: This choice is incorrect because bounding peripheral pulses are not a sign of respiratory acidosis. Bounding peripheral pulses may indicate increased cardiac output, anxiety, or hyperthyroidism, but they do not reﬂect the pH level in the blood.

Choice D Reason: This choice is correct because widened QRS complexes are a sign of respiratory acidosis. QRS complexes are the segments on an electrocardiogram (ECG) that represent the depolarization of the ventricles. A normal QRS complex duration is 0.06 to 0.10 seconds, and a widened QRS complex duration is more than 0.12 seconds. A widened QRS complex may indicate hyperkalemia, which is a common complication of kidney failure and respiratory acidosis. Hyperkalemia is a condition in which the serum potassium level is higher than normal (more than 5 mEq/L). It may cause cardiac arrhythmias, muscle weakness, or paralysis.

A. Hemodynamic status B. Spinal cord perfusion C. Renal function D. Intracranial pressure

Correct Answer is A

Explanation

Choice A Reason: This is correct because a pulmonary artery catheter is a device that measures the pressures and ﬂows in the heart and lungs, such as the pulmonary artery pressure, the pulmonary artery wedge pressure, the cardiac output, and the mixed venous oxygen saturation. These parameters reﬂect the hemodynamic status of the client, which is the balance between the cardiac output and the systemic vascular resistance.

Choice B Reason: This is incorrect because a pulmonary artery catheter does not measure spinal cord perfusion, which is the blood ﬂow to the spinal cord. Spinal cord perfusion can be aﬀected by spinal cord injury, spinal anesthesia, or spinal surgery.

Choice C Reason: This is incorrect because a pulmonary artery catheter does not measure renal function, which is the ability of the kidneys to filter waste products and maintain ﬂuid and electrolyte balance. Renal function can be assessed by urine output, blood urea nitrogen, creatinine, and glomerular filtration rate.

Choice D Reason: This is incorrect because a pulmonary artery catheter does not measure intracranial pressure, which is the pressure inside the skull. Intracranial pressure can be increased by brain injury, stroke, tumor, infection, or hydrocephalus.

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A nurse is caring for a client who has a traumatic head injury and is exhibiting signs of increasing intracranial pressure. Which of the following medications should the nurse plan to administer?

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