With injury to the brain,swelling may occur quickly,requiring aggressive decisions to manage increasing intracranial pressure (ICP).What is an appropriate diuretic medication to give and what nursing actions would be indicated for an older adult patient with traumatic brain injury,increased ICP,and a history of congestive heart failure (CHF)?

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Quizplus · Accepted Answer

Furosemide (Lasix):Adult dose 20-80 mg IV;may increase dose,not to exceed 600 mg/day;monitor for hypotension;note extent of diuresis;watch for changes from initial assessment;loop diuretic helpful in decreasing ICP;influences CSF formation by affecting sodium-water movement across blood-brain barrier and shows preferential excretion of water over solute in distal tubule.Mannitol (Osmitrol):Adult dose 1.5-2 g/kg IV as 20% solution over 30 min;careful evaluation of cardiovascular status:sudden increase in extracellular fluid may lead to fulminating CHF.

With Injury to the Brain,swelling May Occur Quickly,requiring Aggressive Decisions