Which outcome would concern the nurse when the patient's calculated mean arterial pressure (MAP) is below 70 mm Hg?

Increased ICP

Decreased cerebral blood flow (CBF)

Increased cerebral perfusion pressure (CPP)

Normal intracranial pressure

Answer and Explanation

The Correct Answer is B

A.   Increased ICP would be a concern when the MAP falls below 70 mm Hg because reduced blood pressure can lead to inadequate cerebral blood flow and worsen ICP.
B.   Decreased cerebral blood flow (CBF) is also a concern with low MAP, but the priority is maintaining MAP at a sufficient level to ensure adequate perfusion.
C.   Increased CPP is unlikely with a low MAP, as CPP is a product of MAP and ICP.
D.   Normal ICP would be a good outcome; however, with a low MAP, the nurse should be concerned about insufficient cerebral perfusion and the risk of increased ICP.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Put all used cosmetics in a plastic bag for one week to kill any bacteria before reusing: This is not a recommended intervention. Disinfecting or discarding the cosmetics would be better.
B. Disinfect contact lenses by soaking in a cleaning solution for 48 hrs: Bacterial conjunctivitis requires the patient to discard lenses for proper infection control.
C. Discard all opened or used contact lenses and lens care products: Discarding contaminated lenses and care products prevents reinfection.

D. Disinfect all lens care products with prescribed antibiotic drops for one-week post infection: This is not recommended as a general practice; lenses and solutions should be discarded instead.

A. An ICP of 10 mm HG B. An ICP of 15 mm HG C. An ICP of 20 mm HG D. An ICP of 5 mm HG

Correct Answer is C

Explanation

A. An ICP of 10 mm HG is within normal limits.
B. An ICP of 15 mm HG is within normal limits.
C. An ICP of 20 mm Hg is elevated and should be reported immediately as it can indicate worsening conditions like brain swelling or herniation. Normal ICP is typically 5 to 15 mm Hg.
D. An ICP of 5 mm HG is also normal and would not require immediate reporting.

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Which outcome would concern the nurse when the patient's calculated mean arterial pressure (MAP) is below 70 mm Hg?

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