A patient with a traumatic brain injury (TBI) is being mechanically ventilated. The patient has sporadic seizure episodes that last for up to a minute. In taking care of this patient, which of the following interventions are appropriate?

Elevate the head of bed.
Provide a quiet environment and turn off unnecessary lights.


• Providing a relaxing environment such as a quiet, darkened room promotes rest and sleep and also helps reduce intracrancial pressure (ICP) and seizure episodes.

• Elevating head of bed promotes venous flow.

• Suctioning should be limited to when it is necessary because it can increase ICP. Ventilated patients do not need to be suctioned regularly, and should only be suctioned lightly when needed.

• Discussion of the patient’s case should not be done at the bedside, because it may cause emotional distress to the patient.

• While decreasing ventilator support is essential to helping get the patient extubated, at this time it is inappropriate. A decreased support in ventilation will cause the patient to work harder, therefore increasing the ICP to dangerous levels.

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