The health care provider prescribes IV mannitol for a client with an intracranial pressure (ICP) of 22. How will the nurse determine that the medication had the intended effect?

Intracranial pressure (ICP) is now 15.

The patient voids 250 mL over 2 hours.

The patient's pupils are dilated and sluggish.

Seizure behavior is absent.

Answer and Explanation

The Correct Answer is A

A. Intracranial pressure (ICP) is now 15: Mannitol is an osmotic diuretic used to reduce intracranial pressure (ICP). The intended effect of the medication is to lower ICP. A decrease in ICP to 15 mmHg is within the normal range and indicates the medication has worked effectively.

B. The patient voids 250 mL over 2 hours is incorrect. While mannitol promotes diuresis, the amount of urine output alone does not directly indicate a reduction in ICP. The goal is to lower ICP, which is best assessed by measuring the ICP itself.

C. The patient's pupils are dilated and sluggish is incorrect. Dilated and sluggish pupils can be a sign of increased ICP, not a response to effective treatment.

D. Seizure behavior is absent is incorrect. While mannitol can help reduce ICP and potentially prevent seizures, the absence of seizure behavior is not a direct indicator of the medication's effect on ICP.

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Correct Answer is A

Explanation

A. Complete a neurovascular check of the affected extremity: Neurovascular assessment ensures that blood flow and nerve function are intact post-procedure. Complications such as arterial occlusion or hematoma can cause ischemia or nerve damage, making this the priority.

B. Perform passive range of motion: This is not a priority and may not be appropriate immediately post-catheterization as movement of the extremity can increase the risk of bleeding.

C. Assess the gag reflex prior to feeding the client: This applies to clients recovering from sedation during procedures like endoscopy, not cardiac catheterization.

D. Keep the client in high Fowler's position: This is contraindicated post-cardiac catheterization, as elevating the head too much can increase pressure at the puncture site and lead to bleeding.

A. Junctional tachycardia B. Sinus tachycardia C. Atrial flutter D. Ventricular fibrillation

Correct Answer is B

Explanation

A. Junctional tachycardia: Junctional tachycardia originates from the atrioventricular (AV) node, with a faster rate and usually no visible P waves preceding the QRS complexes.

B. Sinus tachycardia: Sinus tachycardia is characterized by a regular, rapid heart rhythm originating from the sinus node, typically seen after exercise, with identifiable P waves before each QRS complex.

C. Atrial flutter: Atrial flutter presents with a “sawtooth” pattern of P waves, indicating rapid atrial contractions, which is different from sinus tachycardia.

D. Ventricular fibrillation: Ventricular fibrillation is a chaotic and irregular rhythm originating from the ventricles, which is a life-threatening condition.

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The health care provider prescribes IV mannitol for a client with an intracranial pressure (ICP) of 22. How will the nurse determine that the medication had the intended effect?

Nursing Test Bank

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