In the first 72 hours following a cerebrovascular accident (CVA), what nursing action is appropriate to prevent increased intracranial pressure (ICP)?

Elevating the head of the bed 25-30 degrees is a critical nursing action in the management of a patient within the first 72 hours following a cerebrovascular accident (CVA) to prevent increased intracranial pressure (ICP). When the head is elevated, it promotes venous drainage from the brain, helping to reduce the pressure within the cranial cavity. This position is effective in allowing gravity to assist in decreasing intracranial blood volume and thus managing swelling in the brain, which can be a concern following a CVA due to potential edema.

In contrast, placing the client in a prone position could adversely affect respiratory function and does not facilitate proper venous drainage, potentially exacerbating ICP. Keeping the client supine flat may also hinder venous return from the brain, leading to increased ICP levels. Encouraging deep breathing exercises could generally be beneficial for respiratory status, but it does not directly address the need to manage ICP in the initial post-CVA timeframe. Proper positioning is a straightforward yet vital intervention that can significantly impact the patient's recovery and help mitigate the risk of complications related to elevated ICP.