Intravenous Fluid Therapy Calculations
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In patients with increased ICP, maintaining cerebral perfusion pressure (CPP) is critical. The Valsalva maneuver (straining during bowel movements, coughing, etc.) increases intrathoracic pressure, which in turn impedes venous return from the brain. This causes a sharp, transient increase in intracranial pressure, which can reduce cerebral blood flow and potentially lead to brain herniation, a life-threatening emergency. Nursing interventions include stool softeners, teaching coughing techniques, and avoiding neck flexion.
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