14. Denny has been diagnosed with cerebral edema. The healthcare provider says that a diuretic will be used to lower his ICP. The nurse anticipates that which diuretic will be prescribed, and why? 15. Mannitol IV has been prescribed.a. When the IV solution of mannitol arrives from the pharmacy, the nurse notes crystals in the fluid. What is the most appropriate action by the nurse? b. What are potential complications the nurse should assess for when administering Mannitol? c. What assessment findings would indicate the mannitol was effective? 16. Denny's mother is very distraught regarding his condition. She entered the room, turned on the lights, lowered the head of the bed and began shaking him to tell him "wake up!" What are your concerns? 17. Epidural bleeds are located between the and the , usually as a result of a linear fracture crossing the artery, and because these bleeds usually involve an artery, the bleeding tends to be , Subdural bleeds occur between the and the , usually affecting the veins that drain into the .
Question
- Denny has been diagnosed with cerebral edema. The healthcare provider says that a diuretic will be used to lower his ICP. The nurse anticipates that which diuretic will be prescribed, and why? 15. Mannitol IV has been prescribed.a. When the IV solution of mannitol arrives from the pharmacy, the nurse notes crystals in the fluid. What is the most appropriate action by the nurse? b. What are potential complications the nurse should assess for when administering Mannitol? c. What assessment findings would indicate the mannitol was effective? 16. Denny's mother is very distraught regarding his condition. She entered the room, turned on the lights, lowered the head of the bed and began shaking him to tell him "wake up!" What are your concerns? 17. Epidural bleeds are located between the and the , usually as a result of a linear fracture crossing the artery, and because these bleeds usually involve an artery, the bleeding tends to be , Subdural bleeds occur between the and the , usually affecting the veins that drain into the .
Solution
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The healthcare provider will likely prescribe Mannitol as the diuretic for Denny. Mannitol is an osmotic diuretic that works by increasing the osmolarity of the blood, which in turn decreases the osmotic pressure in the brain cells, reducing cerebral edema and lowering intracranial pressure (ICP).
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a. If the nurse notes crystals in the fluid of the Mannitol IV solution, the most appropriate action would be to return it to the pharmacy. Crystals indicate that the solution has been cooled and needs to be warmed until the crystals dissolve before it can be administered.
b. Potential complications the nurse should assess for when administering Mannitol include dehydration, electrolyte imbalance, kidney dysfunction, and hypotension.
c. Assessment findings that would indicate the Mannitol was effective include a decrease in ICP, improvement in neurological status (e.g., level of consciousness, pupil response, motor function), and reduction in cerebral edema symptoms.
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The concerns with Denny's mother's actions are that they could potentially increase Denny's ICP. Turning on the lights, lowering the head of the bed, and physical stimulation such as shaking can all lead to an increase in ICP, which could worsen Denny's condition.
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Epidural bleeds are located between the dura mater and the skull, usually as a result of a linear fracture crossing the middle meningeal artery, and because these bleeds usually involve an artery, the bleeding tends to be rapid. Subdural bleeds occur between the dura mater and the arachnoid mater, usually affecting the veins that drain into the superior sagittal sinus.
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