A client has a systolic blood pressure of over 200 mm Hg and a severe headache.
The physician orders a nicardipine infusion. What should the nurse explain to the family about the use of this medication?

Caring for clients with supratentorial gliomas requires knowledge of intracranial pressure (ICP) dynamics. As a tumor grows or edema increases, brain tissue can be displaced. Recognizing early signs of neurological deterioration is vital for preventing brain herniation and permanent neurological damage.

Choice A rationale

Fatigue is a common, non specific symptom in cancer patients due to the metabolic demands of the tumor or treatments. While distressing, it does not indicate an immediate life threatening change in neurological status or increased intracranial pressure.

Choice B rationale

A decreasing level of consciousness is the most sensitive indicator of increased intracranial pressure. It suggests brainstem compression or global cerebral dysfunction, requiring urgent intervention to prevent irreversible injury or herniation from the supratentorial mass.

Choice C rationale

Balance issues or ataxia can occur with brain tumors depending on the location and pressure on motor pathways. While significant for safety and fall risk, it is less acutely concerning than a decline in overall cognitive arousal.

Choice D rationale

Mild nausea can result from increased intracranial pressure or chemotherapy. However, without projectile vomiting or other focal neurological deficits, it is considered a manageable symptom rather than a priority over a change in the client's consciousness level..

This question tests knowledge of silver sulfadiazine, a topical antimicrobial used in burn care. Understanding its mechanism, application techniques, and properties is necessary to evaluate the accuracy of the client's statements regarding its use and therapeutic effects.

Choice A rationale

Silver sulfadiazine is typically applied in a thin layer and may be left open to air or covered with a light dressing. Instructing that a dressing should never be used is incorrect and clinically inaccurate.

Choice B rationale

Silver sulfadiazine is a broad-spectrum antimicrobial agent. Its primary purpose is to prevent and treat sepsis in second-degree and third-degree burns by inhibiting the growth of microorganisms that could lead to systemic or local infection.

Choice C rationale

The medication should be applied to burned areas requiring antimicrobial protection. Applying the cream specifically to open areas prevents unnecessary skin irritation on intact skin while providing targeted treatment to vulnerable, damaged tissues prone to bacterial colonization.

Choice D rationale

Old ointment should be removed before reapplying a new layer, but a tongue blade is used for application, not removal. Removal is generally done by gentle cleansing with water or saline to avoid trauma.

Choice E rationale

Silver sulfadiazine is a white, water-soluble cream. It is not dark in color and is easily removed with water. The statement that it cannot be removed with water indicates a misunderstanding of the product's properties.

Choice F rationale

Silver sulfadiazine has effective antimicrobial properties against a wide range of gram-positive and gram-negative bacteria, as well as yeast such as Candida albicans. This broad coverage makes it a standard choice for burn wound management..