The nurse is caring for a client in the intensive care unit following a closed head injury. The nurse can anticipate which medication would be administered to treat an increase in intracranial pressure?

Choice A reason:

Hyperkalemia refers to high potassium levels, which can occur in ESKD but does not explain the shortness of breath, swelling, or crackles in the lungs. These symptoms are more indicative of fluid overload.

Choice B reason:

Hyponatremia, or low sodium levels, can occur in ESKD but is not directly linked to the symptoms of fluid overload like shortness of breath and crackles. It primarily affects neurological status rather than causing respiratory symptoms.

Choice C reason:

Hypervolemia, or fluid overload, is the likely cause of the client’s symptoms. End-stage kidney disease often leads to the accumulation of fluids in the body due to impaired kidney function, resulting in swelling (edema), shortness of breath, crackles in the lungs, and elevated blood pressure.

Choice D reason:

Hypovolemia, or low blood volume, would typically present with hypotension and dehydration rather than the fluid overload symptoms observed in this client.

Choice A reason:

Pepcid (famotidine) is an H2 receptor antagonist used to reduce stomach acid production. It is not relevant to the management of increased intracranial pressure and does not have the pharmacological properties needed to treat such a condition. Its primary use is for gastrointestinal issues.

Choice B reason:

Aspirin is an anti-inflammatory and antiplatelet medication that is not suitable for treating increased intracranial pressure. In fact, it could be contraindicated due to the risk of bleeding, especially in a patient with a head injury. Aspirin can exacerbate intracranial bleeding and worsen the situation.

Choice C reason:

Desmopressin is used to manage conditions like diabetes insipidus and certain bleeding disorders, but it is not used to treat increased intracranial pressure. Its action on fluid retention and blood clotting does not address the direct need for reducing intracranial pressure.

Choice D reason:

Mannitol is an osmotic diuretic that is effective in reducing intracranial pressure. It works by drawing fluid out of the brain tissue, thereby decreasing pressure within the skull. This makes it the appropriate medication for managing increased intracranial pressure in the scenario of a closed head injury.