امرأة عمرها ٤٠ سنة في العناية بعد نزيف تحت العنكبوتية، منببة، وضغط الجمجمة ٢٢ ملم زئبق. عندها إفرازات في الأنبوب، والممرض يخطط رعايته للمناوبة. أي إجراء تمريضي قد يرفع الضغط داخل الجمجمة ويحتاج تقليله؟

A 40-year-old woman in ICU after subarachnoid haemorrhage is intubated with ICP 22 mmHg and has secretions in the tube. The nurse is planning care for the shift. Which nursing action may raise ICP and should be minimised?

1. Keeping the head in midline
2. Prolonged, repeated tracheal suctioning
3. Clustering care with rest periods between
4. Keeping the room quiet with dim lighting

Answer: B) Prolonged, repeated tracheal suctioning. Suctioning, coughing, pain and frequent handling raise ICP. Suction only when needed, briefly, with pre-oxygenation, and spread activities with rest.