Question

The nurse is caring for a client with a head injury. When administering mannitol (Osmitrol), which precaution should the nurse take? A. Obtain a filter for the IV tubing B. Have flumazenil (Romazicon) available at the bedside C. Hyperventilate the client before administration D. Assess the client's WBC count

Short answer

Answer: Obtain a filter for the IV tubing

Step-by-step solution

Identifying the purpose of mannitol administration

Mannitol (Osmitrol) is an osmotic diuretic primarily used for reducing intracranial pressure in clients with head injuries. Knowing the purpose of mannitol administration will make it easier to analyze the precautions mentioned in the options.

Analyzing each option

Let's examine each of the given options one-by-one: A. Obtain a filter for the IV tubing: Mannitol has a tendency to crystallize at lower temperatures, therefore, using a filter during the administration of mannitol via IV tubing is advised. B. Have flumazenil (Romazicon) available at the bedside: Flumazenil (Romazicon) is an antidote used to reverse the effects of benzodiazepines in case of overdose. This is not directly related to the administration of mannitol. C. Hyperventilate the client before administration: Hyperventilation is not indicated before mannitol administration. Instead, hyperventilation might be used to quickly reduce intracranial pressure in emergency scenarios, but it is not directly related to mannitol infusion. D. Assess the client's WBC count: While general assessment and monitoring of a client's condition is necessary, checking the WBC count is not a specific precaution related to the administration of mannitol.

Selecting the correct answer

Based on the analysis of each option, the correct answer is: A. Obtain a filter for the IV tubing Using a filter during mannitol administration prevents any crystallized particles from entering the client's bloodstream.

Key concepts

Head Injury Management

Managing a head injury is a critical aspect of nursing care. It involves a systematic approach to assessment and intervention, ensuring the patient's safety and preventing further harm.

When dealing with head injuries, nurses must be vigilant in monitoring the patient's neurological status, looking for any signs of deterioration.

• Gently assess the level of consciousness and orientation.
• Check pupil response to light.
• Monitor for symptoms such as vomiting, headache, or confusion.
• Maintain cervical spine stability until injury is ruled out.

Prompt intervention can greatly influence outcomes, so a proactive approach is essential. Understanding the mechanisms leading to increased intracranial pressure or potential bleeding helps make informed decisions on patient care.

Intracranial Pressure

Intracranial pressure (ICP) refers to the pressure within the skull, affecting the brain tissue and cerebrospinal fluid.

Normal ICP levels range from 7 to 15 mmHg.
Elevated ICP can result from trauma, bleeding, or swelling, leading to potentially life-threatening conditions.

• Signs of increased ICP include severe headache, altered mental status, and changes in vision.
• Pupil enlargement and irregular breathing are critical warning signs.
• Regular monitoring includes using tools like intracranial pressure monitoring devices if available.
• Medical interventions, such as medications or surgical procedures, may be required based on severity.

Understanding ICP is crucial for assessing patient progress and implementing timely interventions.

Medication Administration

Administering medication in nursing care requires meticulous attention to detail, especially in cases involving critical care drugs like mannitol.

Nurses must verify the correct medication, dosage, and route of administration, ensuring it aligns with the patient's current needs and conditions.

• Before administering, review the patient's medical history and possible contraindications.
• Conduct checks for allergies and existing medications to prevent interactions.
• Observe for potential side effects post-administration.
• Document every step of medication administration accurately.

Such diligence minimizes errors and enhances patient safety during treatment.

Mannitol Precautions

Mannitol is an osmotic diuretic frequently used to manage elevated intracranial pressure in head injury cases.

It’s crucial to take specific precautions during administration to avoid complications.
The most important precaution involves using an inline filter during intravenous administration.

• Mannitol can crystallize easily; a filter prevents these particles from entering the bloodstream.
• Ensure the solution is clear and free of crystals before administration.
• Correct storage and warming of mannitol is vital to maintain its efficacy and safety.

Moreover, continually monitor the patient's response to mannitol, watching for changes in urine output and signs of electrolyte imbalance.
Such vigilance ensures effective management of intracranial pressure and enhances patient outcomes.