Critical Care Registered Nurse (CCRN) Practice Exam

What should a nurse monitor for signs of increased intracranial pressure (ICP) after a craniotomy?

1. Change in appetite

2. Pupil changes and weakness in extremities

3. Skin color and hydration status

4. Heart rate and respiratory rate

The correct answer is: Pupil changes and weakness in extremities

Monitoring for signs of increased intracranial pressure (ICP) after a craniotomy is critical due to the potential for serious complications. Pupil changes can indicate pressure on the optic nerve or brainstem, with altered size or reactivity suggesting increased ICP or herniation. Additionally, weakness in extremities can signify neurological deficits as a result of increased pressure affecting brain function. This combination of symptoms reflects a direct effect on the central nervous system's integrity and should be closely observed. While changes in appetite, skin color, hydration status, heart rate, and respiratory rate can be important signs in a clinical setting, they are not specific indicators of ICP. Pupil response and motor function more directly correlate with the brain's condition and the potential for increased pressure that can compromise cerebral perfusion and function. Thus, monitoring these neurological signs is essential for early detection and intervention.