A nurse is planning care for a client who has dementia and lives at home. Which of the following physiological changes should the nurse educate the client and family to monitor?

A. Colchicine:

Colchicine is commonly used in the treatment of pericarditis, especially in cases of recurrent or refractory pericarditis.

It helps reduce inflammation and alleviate symptoms by inhibiting the migration of neutrophils to the inflamed pericardium.

Colchicine is often used in conjunction with nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids for the management of pericarditis.

B. Acetaminophen:

Acetaminophen is a pain reliever and fever reducer commonly used to manage mild to moderate pain associated with various conditions, including pericarditis.

While acetaminophen may provide symptomatic relief, it is not typically considered a primary treatment for pericarditis, especially in cases of severe or recurrent pericarditis.

C. Indomethacin:

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that can help reduce inflammation and relieve pain associated with pericarditis.

NSAIDs are often used as first-line therapy for acute pericarditis to alleviate symptoms such as chest pain and fever.

However, caution should be exercised when using NSAIDs in certain populations, such as older adults or those with preexisting gastrointestinal or renal conditions.

D. Amiodarone:

Amiodarone is an antiarrhythmic medication used to treat various types of arrhythmias, including ventricular arrhythmias and atrial fibrillation.

While pericarditis may lead to certain arrhythmias, such as atrial fibrillation, amiodarone is not a first-line treatment for pericarditis itself.

However, it may be used in cases where pericarditis is complicated by arrhythmias or concomitant cardiac conditions.

E. Nitroglycerine:

Nitroglycerine is a vasodilator medication commonly used to treat angina and heart failure.

While pericarditis may cause chest pain similar to angina, nitroglycerine is not typically used as a primary treatment for pericarditis.

In fact, nitroglycerine may exacerbate symptoms of pericarditis by causing venodilation and increasing cardiac preload.

A. Completing hourly endotracheal suctioning: Hourly endotracheal suctioning is not typically indicated for a client with increased intracranial pressure (ICP). Frequent suctioning can lead to increased intrathoracic pressure and potentially compromise venous return, which may further elevate ICP. Suctioning should be performed as needed to maintain airway patency while minimizing the risk of increasing ICP.

B. Ensuring proper ventriculostomy transducer levels: Ensuring proper ventriculostomy transducer levels is important for accurate measurement of intracranial pressure (ICP) but may not directly alleviate elevated ICP. Monitoring ICP through ventriculostomy allows for timely detection of changes in ICP, which can guide interventions to manage elevated pressure levels. However, it is not a direct intervention to reduce ICP.

C. Monitoring volume status: Monitoring volume status is important in managing a client with increased intracranial pressure (ICP) as both hypovolemia and hypervolemia can impact ICP. However, monitoring volume status alone does not directly address elevated ICP. Interventions to optimize volume status, such as fluid administration or diuresis, may be implemented based on assessment findings, but they should be done cautiously to avoid exacerbating cerebral edema or altering cerebral perfusion.

D. Elevating the head of the bed 15°: Elevating the head of the bed 15° (or higher) is a crucial intervention for managing a client with increased intracranial pressure (ICP). This position helps promote venous drainage from the brain, reducing venous congestion and intracranial pressure. Elevating the head of the bed also helps prevent cerebrospinal fluid (CSF) from pooling in the brain, which can further increase ICP. Placing the client in a semi-upright position is a standard practice in managing ICP and is recommended in various clinical guidelines.