For a patient with suspected increased intracranial pressure, which nursing action is appropriate?

• A. Elevate head of bed to 30-45 degrees
• B. Suction every 2 hours on a schedule
• C. Schedule group activities to allow downtime
• D. Use an ice mattress to keep the patient comfortable

Answer: (A)

Elevating the head of the bed to 30-45 degrees helps lower intracranial pressure by promoting venous drainage from the brain and reducing venous return stasis. When the head is up and kept midline, blood can flow more easily from the brain to the heart, which helps decrease ICP while preserving cerebral perfusion. This position also limits neck flexion and brainstem compression risk, supporting better airway management and oxygenation.

Suctioning on a fixed schedule can provoke coughing or gagging and cause brief spikes in ICP, so it’s not the best choice for ICP control. Scheduling group activities increases sensory stimulation and metabolic demand, which can worsen ICP. An ice mattress isn’t a standard ICP management measure and can lead to shivering and increased metabolic demand, potentially raising ICP.