You receive a patient in the ED who fell and hit their head. You walk into your patient's room to do an assessment. You notice they have bruising behind their ears and around their eyes. What are you most concerned about?

A. Normal ICP is incorrect because normal intracranial pressure ranges from 5 to 15 mmHgin adults. Values above 20 mmHg are considered elevated, and sustained ICP above 20–25 mmHg is critically highand requires urgent intervention.

B. Mildly elevated ICP is incorrect because ICP of 28 mmHg exceeds mild elevation, which is generally considered 20–25 mmHg. This patient’s ICP is above that range and represents a dangerous level.

C. Critically elevated ICP is correct. An ICP of 28 mmHg indicates critically elevated intracranial pressure, especially when accompanied by low CPP (normal 60–70 mmHg)and hypercapnia (PaCO2 60 mmHg). Hypercapnia causes cerebral vasodilation, further increasing ICP and worsening cerebral perfusion. Immediate interventions are required to reduce ICP, optimize CPP, and prevent secondary brain injury.

A. Lean meats is incorrect because protein intake is important for patients on hemodialysisto replace protein lost during treatment. Lean meats are generally encouraged, though intake may be adjusted based on lab values such as BUN and albumin.

B. Fresh fruits is partially correct, but not all fruits need to be restricted. Fruits that are low in potassiumcan usually be eaten in moderation. The main concern is fruits high in potassium.

C. Whole grains is incorrect because whole grains provide fiber and other nutrients. They are generally not restricted unless there are specific concerns related to phosphorus content, which can sometimes require portion control.

D. Bananas and oranges is correct because these fruits are high in potassium, which can accumulate in patients with renal failure. Elevated potassium levels (hyperkalemia) are dangerous and can lead to cardiac arrhythmias or arrest. Patients on hemodialysis need to monitor and often limit high-potassium foods.