مريض بعد إصابة رأس شديدة مع ارتفاع الضغط داخل الجمجمة، ولديه إفرازات صدرية. أي إجراء يجب تجنبه؟

A client with a severe head injury and raised intracranial pressure has chest secretions. Which intervention must be avoided?

1. Careful turning with the head kept midline
2. Head-down postural drainage
3. Head of bed elevated to 30 degrees
4. Brief suctioning with pre-oxygenation

Answer: B) Head-down postural drainage. Head-down positioning raises intracranial pressure, so it is avoided in head injury. The head stays elevated 30 degrees and midline, and suction is brief with pre-oxygenation.