A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse take?

Choice A reason: Teaching controlled coughing and deep breathing is contraindicated in increased intracranial pressure, as these actions can raise intrathoracic pressure, impeding cerebral venous drainage and further elevating ICP. Gentle respiratory support may be needed, but avoiding maneuvers that increase pressure is critical to prevent brain injury. Choice B reason: Elevating the head of the bed (30–45 degrees) is appropriate for increased intracranial pressure. This position promotes cerebral venous drainage, reducing blood volume in the cranial vault and lowering ICP. It helps prevent complications like brain herniation by optimizing cerebral perfusion and pressure dynamics. Choice C reason: Encouraging 4,000 mL of clear fluids daily is inappropriate, as excessive fluid intake can increase cerebral edema and intracranial pressure. Fluid restriction or careful monitoring is often required to maintain euvolemia, preventing exacerbation of brain swelling and ensuring stable intracranial dynamics in this condition. Choice D reason: Providing a brightly lit environment is contraindicated, as bright light can exacerbate neurological symptoms and increase agitation in clients with elevated ICP. A dim, quiet environment reduces stimuli, minimizing stress and potential ICP spikes, supporting safer recovery from intracranial pressure elevation.