A nurse admits a client who has a subarachnoid hemorrhage and expects to administer medication to decrease intracranial pressure (ICP). Which of the following medications should the nurse administer?

Choice A rationale

Decreased visual acuity, a common age-related change, significantly impairs an older adult's ability to perceive environmental hazards such as uneven surfaces or obstacles. This sensory deficit directly increases the risk of tripping and falling, leading to head injuries.

Choice B rationale

While older adults can be involved in motor vehicle crashes, it is not considered one of the *common reasons* for head injuries specifically *due to falls* in this demographic. Falls are a far more prevalent cause of head injuries in the elderly population compared to vehicular accidents.

Choice C rationale

Polypharmacy, the concurrent use of multiple medications, often leads to adverse drug reactions like orthostatic hypotension, dizziness, and altered gait. These side effects compromise balance and increase the likelihood of falls, a primary cause of head injuries in older adults.

Choice D rationale

Age-related sarcopenia and generalized muscle weakness diminish an older adult's ability to maintain balance and recover from a stumble. Weakness in lower extremities particularly reduces postural stability, making falls more probable and increasing susceptibility to head trauma.

Choice E rationale

Chronic hypertension itself does not directly cause falls or head injuries. However, poorly controlled hypertension or its treatment can sometimes lead to orthostatic hypotension, which can then contribute to falls. The direct link is less prominent than other factors.

Choice F rationale

Previous military experience has no direct scientific correlation with an increased risk of head injuries due to falls in older adults. This factor is irrelevant to the physiological and environmental causes of falls in the elderly population.

Choice A rationale

A myasthenic crisis is a life-threatening exacerbation of myasthenia gravis characterized by severe muscle weakness, particularly affecting the respiratory muscles. This can lead to impending or actual respiratory failure, necessitating immediate intervention with mechanical ventilation to support breathing and prevent hypoxemia and hypercapnia.

Choice B rationale

A vasoconstrictor would elevate blood pressure by constricting blood vessels. Myasthenic crisis primarily involves profound muscle weakness, not typically hypotensive states requiring vasoconstrictors. Administering a vasoconstrictor would not address the underlying respiratory compromise or muscle weakness.

Choice C rationale

Pursed-lip breathing is a technique used to prolong exhalation and improve ventilation in individuals with obstructive lung diseases like COPD. While it can help with dyspnea, it is insufficient to manage the severe respiratory muscle weakness seen in a myasthenic crisis and would not prevent respiratory failure.

Choice D rationale

Sedatives depress the central nervous system and can further impair respiratory drive and muscle function, which would be detrimental in a myasthenic crisis. The client's respiratory status is already compromised, and sedation would exacerbate hypoventilation and increase the risk of respiratory arrest.