Which of the following clinical manifestations would a client with Huntington’s disease exhibit?

Choice A reason: A heart rate drop from 76 to 70 is minor and not specific to worsening TBI. A Glasgow Coma Scale decline indicates neurological deterioration, making this incorrect.

Choice B reason: Ataxia suggests coordination issues, concerning but less urgent than a Glasgow Coma Scale drop. Altered consciousness is a priority, making this incorrect for immediate reporting.

Choice C reason: Diplopia is concerning but less critical than a Glasgow Coma Scale decrease. Visual changes are secondary to consciousness decline, making this incorrect for immediate action.

Choice D reason: A Glasgow Coma Scale drop from 13 to 11 indicates worsening neurological status, potentially from increasing ICP. This requires immediate reporting, making it the correct choice.

Choice A reason: Log rolling maintains spinal alignment when repositioning a client with increased ICP, preventing further pressure on the brain from misalignment. Elevated ICP, often from cerebral edema or hemorrhage, requires careful movement to avoid exacerbating intracranial hypertension, making this a safe and appropriate nursing action.

Choice B reason: Coughing and deep breathing increase intrathoracic pressure, which can elevate ICP by impeding venous return from the brain. In clients with increased ICP due to trauma, this can worsen cerebral edema or herniation, making it an unsafe action that contradicts neurological care principles.

Choice C reason: A warming blanket can increase metabolic demand and vasodilation, potentially raising ICP by increasing cerebral blood flow. In closed-head injuries, maintaining normothermia is critical to minimize brain swelling, as hyperthermia exacerbates neuronal injury, making this an inappropriate intervention.

Choice D reason: A supine position without head elevation can increase ICP by impairing cerebral venous drainage due to gravity. Elevating the head of the bed (30-45 degrees) is standard to reduce ICP in closed-head injuries, as it promotes venous outflow, making this an incorrect choice.