A client with hydrocephalus is admitted to the neurological intensive care unit with increased intracranial pressure. Which nursing interventions would the nurse include in the plan of care? Select all that apply.

Hydrocephalus with increased intracranial pressure (ICP) is a neurological emergency characterized by excessive accumulation of cerebrospinal fluid within the ventricles, leading to compression of brain tissue. This condition can rapidly impair cerebral perfusion and cause neurological deterioration. Nursing management focuses on preventing further increases in ICP, early detection of neurological decline, and protecting the patient from complications such as seizures and brain herniation. Interventions aim to maintain stable intracranial dynamics and ensure close monitoring. A. Hourly neurological checks are essential in a patient with increased ICP due to hydrocephalus because changes in level of consciousness, pupil response, motor function, and vital signs may indicate worsening cerebral edema or impending herniation. Frequent assessments allow for early detection of deterioration and timely intervention to prevent irreversible brain damage. B. Administration of half-normal saline is not appropriate in increased ICP management because hypotonic fluids can worsen cerebral edema by promoting fluid shift into brain tissue. In patients with Hydrocephalus, isotonic fluids are preferred to maintain cerebral perfusion without increasing intracranial swelling. C. Encouraging coughing and deep breathing is contraindicated in increased ICP because these actions increase intrathoracic and intrathoracic pressure, which can subsequently raise intracranial pressure. In a patient with Hydrocephalus, such activities may worsen cerebral perfusion and should be minimized or carefully controlled. D. Decreasing environmental stimuli is an important intervention because noise, light, and excessive handling can increase cerebral metabolic demand and raise intracranial pressure. Creating a calm, quiet environment helps reduce stimulation and supports stabilization of ICP in patients with Hydrocephalus. E. Placing the client in Trendelenburg position is contraindicated because it increases venous return to the head, thereby elevating intracranial pressure. In patients with Hydrocephalus, positioning should instead promote drainage, typically with the head of the bed elevated at about 30 degrees. F. Seizure precautions are appropriate because increased ICP and underlying brain tissue compression significantly increase the risk of seizures. Patients with Hydrocephalus require protective measures such as padded side rails and readily available suction equipment to ensure safety during potential seizure activity.