The nurse is educating on the placement of a ventriculostomy (intraventricular catheter) to the patient diagnosed with a brain injury and their family. The nurse states, "The ventriculostomy is placed:
after the client has an electroencephalogram (EEG)."
due to having minimal risk for infection."
by threading it through the femoral artery to the brain."
to monitor intracranial pressure (ICP) and drain the cerebral spinal fluid."
The Correct Answer is D
A. EEG is a monitoring tool for brain activity, but it is not a prerequisite for ventriculostomy placement.
B. While the procedure is carefully managed to reduce infection risk, ventriculostomy does have an infection risk due to its invasive nature.
C. Ventriculostomy is not inserted via the femoral artery; it is placed directly in the brain’s ventricles.
D. A ventriculostomy is used to monitor ICP and allows for the drainage of cerebrospinal fluid, which helps in managing elevated ICP in patients with brain injuries.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. While taking some medications with food or milk can help with absorption, this is not a specific requirement for lisinopril.
B. Lisinopril, an ACE inhibitor, can lead to elevated potassium levels. Periodic monitoring of potassium levels is essential to prevent hyperkalemia, a potentially dangerous side effect.
C. Increasing intake of green vegetables is generally healthy but does not directly impact lisinopril's effects.
D. Many salt substitutes contain potassium, which could elevate potassium levels further when taken with ACE inhibitors like lisinopril, posing a risk for hyperkalemia.
Correct Answer is A
Explanation
A. Altered mental status, such as confusion, restlessness, or lethargy, is often the earliest sign of increasing ICP as it reflects brain tissue compression.
B. Tachycardia and hypotension are not primary indicators of elevated ICP.
C. Fixed and dilated pupils indicate severe and often irreversible ICP increase, occurring later in the progression.
D. Widening pulse pressure is a later sign of increased ICP, following changes in mental status.
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