A nurse is evaluating an infant who received treatment for increased intracranial pressure. Which of the following findings should the nurse identify as an indication that the treatment was effective?

Management of increased intracranial pressure (ICP) in infants focuses on reducing cerebral swelling and preventing further neurologic damage. Because the infant skull has open sutures and fontanels, changes in intracranial pressure can often be assessed through physical examination findings. Effective treatment should result in decreased intracranial pressure, reflected by improved neurologic status and normalization of skull-related signs. Nurses monitor for indicators that suggest reduced cerebral pressure and improved brain perfusion. Rationale: A. Increased sleepiness may indicate worsening neurologic status rather than improvement. In infants with elevated ICP, lethargy can be a sign of decreased cerebral perfusion and progressing neurologic impairment. Therefore, increased drowsiness would not indicate treatment effectiveness. B. Enlarged head circumference suggests ongoing or worsening intracranial pressure rather than improvement. In infants, increased ICP can lead to progressive head enlargement due to the flexibility of skull sutures. This finding would indicate ineffective treatment or disease progression. C. Soft, flat fontanels indicate that intracranial pressure has decreased to a normal or near-normal level. When ICP is elevated, fontanels become bulging and tense due to increased cerebrospinal fluid pressure. A soft, flat fontanel is a key sign that treatment has been effective in reducing intracranial pressure. D. Crying when disturbed is a nonspecific finding and may be normal in infants due to discomfort or environmental stimulation. Although it may indicate irritability, it is not a reliable indicator of intracranial pressure status. Effective ICP treatment is better evaluated through objective physical signs such as fontanel assessment and neurologic responsiveness.