A right-handed patient has been admitted with an intracerebral hemorrhage.A computed tomography (CT)of the patient's head reveals a large left parietal area bleed.Patient assessment includes temperature (T),98.7° F; pulse (P),98 beats/min and thready; respirations (R),8 breaths/min; and blood pressure (BP),168/100 mm Hg.Initial management of the patient includes which intervention?
A) Placing the patient in the Trendelenburg position
B) Administering an antihypertensive agent
C) Initiating induced hypertensive therapy
D) Intubating and ventilating the patient

Question

Quizplus · Accepted Answer

Intracerebral hemorrhage is a medical emergency.Initial management requires attention to airway,breathing,and circulation.Intubation is usually necessary.Blood pressure management must be based on individual factors.Reduction in blood pressure is usually necessary to decrease ongoing bleeding,but lowering blood pressure too much or too rapidly may compromise cerebral perfusion pressure,especially in a patient with elevated intracranial pressure.National guidelines recommend keeping the mean arterial blood pressure below 130 mm Hg in patients with a history of hypertension by moderate blood pressure reduction to a mean arterial pressure below 110 mm Hg.Vasopressor therapy after fluid replenishment is recommended if systolic blood pressure falls below 90 mm Hg.

A Right-Handed Patient Has Been Admitted with an Intracerebral Hemorrhage