NCLEX-PN® ExaminationPhysiological AdaptationMedium
A client with a traumatic brain injury (TBI) is exhibiting signs of increased intracranial pressure (ICP), including a Glasgow Coma Scale (GCS) score of 8, unilateral pupillary dilation, and decorticate posturing. The nurse should anticipate administering which medication to reduce cerebral edema?
- ADexamethasone
- BPhenytoin
- CVasopressin
- DMannitol
Show answer & explanationAnswer & explanation
Correct answer: D. Mannitol
Mannitol is an osmotic diuretic used to reduce cerebral edema and lower ICP by drawing fluid from brain tissue into the vascular space. Vasopressin is an antidiuretic, phenytoin is an anticonvulsant, and dexamethasone is a corticosteroid, which is less effective for acute TBI edema than for vasogenic edema from tumors.
Why the other options are wrong
- A. Dexamethasone is a corticosteroid, primarily used for vasogenic edema (e.g., from tumors), not typically for acute TBI-related edema.
- B. Phenytoin is an anticonvulsant and does not directly reduce cerebral edema or ICP.
- C. Vasopressin is an antidiuretic hormone and would worsen cerebral edema by retaining fluid.
ICP Management: Mannitol
Mannitol is an osmotic diuretic used to rapidly decrease increased intracranial pressure (ICP) by reducing cerebral edema.
- Administered intravenously.
- Works by creating an osmotic gradient, pulling fluid from brain tissue into the bloodstream.
- Requires careful monitoring of fluid and electrolyte balance, and serum osmolality.
Memory trick: Mighty Mannitol Makes ICP Melt.