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# **Nursing Management** ## **Slide 20 of 36** ### **Maintaining Fluid Balance** - Prevent I.V. fluid overload, which may worsen cerebral edema. - Monitor intake and output closely. - Monitor CVP frequently. - Administration of osmotic diuretic - mannitol ### **Reducing Pain** - Assess level,...

# **Nursing Management** ## **Slide 20 of 36** ### **Maintaining Fluid Balance** - Prevent I.V. fluid overload, which may worsen cerebral edema. - Monitor intake and output closely. - Monitor CVP frequently. - Administration of osmotic diuretic - mannitol ### **Reducing Pain** - Assess level, intensity, duration and location of pain. - Darken the room if photophobia is present. - Assist with position of comfort for neck stiffness and turn patient slowly and carefully with head and neck in alignment. - Elevate the head of the bed to decrease ICP and reduce pain. - Administer analgesics as ordered - monitor for response and adverse reactions. - Avoid opioids, which may mask a decreasing LOC. ### **Promoting Return to Optimal Level of Functioning** - Implement rehabilitation interventions after admission (eg, turning, positioning). - Progress from passive to active exercises based on the patient's neurologic status. ### **Nursing Management** - Assess neurologic status and vital signs constantly (2-4hrly). - Determine oxygenation from arterial blood gas values and pulse oximetry. - Assess blood pressure, which precedes cardiac or respiratory failure. - Rapid IV fluid replacement may be prescribed - Do not overhydrate patient because of the risk of cerebral edema.