After a frontal craniotomy, a patient returns to the neurosurgery unit. Which of the following orders might the nurse expect for the patient?

Elevate the head of the bed at 30 degrees.
Give dexamethasone 4 mg every six hours.
Provide oxygen at 2 liters per minute.


• Administering oxygen at 2 liters per minute is an appropriate order. Oxygen is needed to prevent hypoxia that could lead to cerebral edema.

• Orders to administer dexamethasone would be expected. Dexamethasone can reduce or prevent cerebral edema.

• Raising the head of the bed to 30 degrees reduces cerebral edema.

• Putting the patient in Trendelenburg's position would be contraindicated because it would increase blood flow to the brain, raising ICP.

• Clustering activities is not advised because it can contribute to raised ICP. Spacing activities out allows the patient's ICP to come back to baseline before performing any other activities.

• Infusing IV fluids at 160 ml/hr may be too high for this patient. It can lead to fluid overload and increased ICP. Following a craniotomy, a patient’s fluid intake is restricted to 1-2 liters per day.

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