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The nurse is caring for a client who was admitted 24 hours ago with a traumatic brain injury. Which medications would the nurse anticipate being prescribed to reduce cerebral edema and prevent a secondary brain injury? Select All That Apply

Morphine

Lactated Ringers

Selected Medications

Dexamethasone

Mannitol

Hypertonic saline

Furosemide

Answer and Explanation

Correct Answer : D,E,F,G

A. Morphine is typically used for pain relief, but it is not used to reduce cerebral edema.

B. Lactated Ringers is a balanced electrolyte solution, but it does not address the need for reducing cerebral edema.

D. Dexamethasone is a corticosteroid used to reduce inflammation and cerebral edema in cases of brain injury.

E. Mannitol is an osmotic diuretic used to reduce cerebral edema by drawing fluid out of the brain and into the bloodstream.

F. Hypertonic saline is used to increase serum osmolality, helping to pull water out of the brain and reduce edema.

G. Furosemide is a loop diuretic that can also help reduce cerebral edema by promoting diuresis.

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Correct Answer is C

Explanation

A. It occurs immediately when buttons depressed: The device synchronizes with the R wave and does not deliver the shock immediately.

B. It requires a higher amount of joules than is used in defibrillation: Cardioversion typically requires fewer joules compared to defibrillation.

C. It discharges during ventricular depolarization of the heart: Synchronized cardioversion times the electrical shock with the R wave (ventricular depolarization) to avoid delivering energy during the T wave, which could induce ventricular fibrillation.

D. It is programmed to occur in non-sync mode: Cardioversion must be synchronized; non-sync mode is used in defibrillation.

A. Intracranial pressure (ICP) is now 15. B. The patient voids 250 mL over 2 hours. C. The patient's pupils are dilated and sluggish. D. Seizure behavior is absent.

Correct Answer is A

Explanation

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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The nurse is caring for a client who was admitted 24 hours ago with a traumatic brain injury. Which medications would the nurse anticipate being prescribed to reduce cerebral edema and prevent a secondary brain injury? Select All That Apply

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