A nurse is caring for a client who has increased intracranial pressure (ICP) following a closed-head injury. Which of the following actions should the nurse take?

Choice A reason: Log rolling maintains spinal alignment when repositioning a client with increased ICP, preventing further pressure on the brain from misalignment. Elevated ICP, often from cerebral edema or hemorrhage, requires careful movement to avoid exacerbating intracranial hypertension, making this a safe and appropriate nursing action. Choice B reason: Coughing and deep breathing increase intrathoracic pressure, which can elevate ICP by impeding venous return from the brain. In clients with increased ICP due to trauma, this can worsen cerebral edema or herniation, making it an unsafe action that contradicts neurological care principles. Choice C reason: A warming blanket can increase metabolic demand and vasodilation, potentially raising ICP by increasing cerebral blood flow. In closed-head injuries, maintaining normothermia is critical to minimize brain swelling, as hyperthermia exacerbates neuronal injury, making this an inappropriate intervention. Choice D reason: A supine position without head elevation can increase ICP by impairing cerebral venous drainage due to gravity. Elevating the head of the bed (30-45 degrees) is standard to reduce ICP in closed-head injuries, as it promotes venous outflow, making this an incorrect choice.