A nurse is planning care for a client who has increased intracranial pressure following a head injury. Which of the following medications should the nurse plan to administer?

Nursing management of a client with increased intracranial pressure (ICP) following head injury focuses on reducing cerebral edema, maintaining adequate cerebral perfusion, and preventing further neurological damage. Elevated ICP can compromise brain oxygenation by decreasing cerebral blood flow and leading to herniation if not promptly managed. Pharmacologic interventions are often used alongside positioning and ventilation strategies to reduce brain swelling. Mannitol is a key medication used to decrease intracranial pressure by drawing fluid out of brain tissue into the intravascular space. Rationale: A. Nitroprusside is a potent vasodilator used to manage severe hypertension, but it is not appropriate in increased intracranial pressure because it can cause cerebral vasodilation. This may increase cerebral blood flow and worsen intracranial pressure. Additionally, rapid blood pressure changes may reduce cerebral perfusion, further compromising brain tissue oxygenation. B. Propranolol is a beta-blocker primarily used for hypertension, angina, and arrhythmias. It does not reduce intracranial pressure and has no role in managing cerebral edema. Its cardiovascular effects may even mask signs of worsening neurologic status such as tachycardia. C. Mannitol is appropriate because it is an osmotic diuretic that reduces intracranial pressure by pulling fluid from swollen brain tissue into the bloodstream. This decreases cerebral edema and improves cerebral perfusion pressure. It is a standard emergency treatment in clients with head injury and elevated ICP. D. Hydrochlorothiazide is a thiazide diuretic used mainly for chronic hypertension and mild fluid overload. It does not effectively reduce intracranial pressure because it lacks the strong osmotic effect needed to shift fluid out of brain tissue. Therefore, it is not indicated for acute management of increased ICP.