When caring for a client who is at risk for increased intracranial pressure (ICP), which intervention should the nurse implement to assist in stabilizing ICР?

Rationale: A. Suction oral cavity frequently to maintain a patent airway: Frequent suctioning increases intrathoracic pressure and can transiently elevate intracranial pressure due to stimulation of the vagus nerve and coughing. Suctioning should be performed only when necessary. B. Keep client’s head in a midline position with head raised 30°: Maintaining the head midline and elevating it to about 30 degrees promotes optimal venous drainage from the brain and prevents obstruction of jugular venous outflow. This position effectively stabilizes or lowers intracranial pressure while maintaining cerebral perfusion. C. Extend neck with a soft collar placed at base of client’s skull: Neck extension can impede venous return from the brain, leading to increased intracranial pressure. Proper alignment, rather than extension or flexion, is critical to allow unobstructed cerebral venous drainage. D. Turn entire body from side to side at least every 2 hours: Repositioning is important for preventing pressure injuries, but abrupt or improper turning can cause surges in intracranial pressure. Movements should be slow and coordinated, with careful head and neck alignment.