Which of the following would have the physiological effect of decreasing intracranial pressure (ICP)?
A . Increased core body temperature
B . Decreased serum osmolality
C . Administration of hypo-osmolar fluids
D . Decreased PaCO2
Answer: D
Explanation:
(A) An increase in core body temperature increases metabolism and results in an increase in ICP.
(B) Decreased serum osmolality indicates a fluid overload and may result in an increase in ICP.
(C) Hypo-osmolar fluids are generally voided in the neurologically compromised. Using IV fluids such as D5W results in the dextrose being metabolized, releasing free water that is absorbed by the brain cells, leading to cerebral edema.
(D) Hypercapnia and hypoventilation, which cause retention of CO2 and lead to respiratory acidosis, both increase ICP. CO2 is the most potent vasodilator known.
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