What sign indicates that a client may be experiencing increased ICP after a traumatic brain injury?

Projectile vomiting is a significant indicator of increased intracranial pressure (ICP) following a traumatic brain injury. This symptom can arise due to irritation of the brain structures as a result of swelling or pressure within the cranial cavity. When ICP increases, it can lead to disturbances in various brain functions, including those associated with the vomiting reflex.

This type of vomiting is often characterized by its sudden onset and can occur without the usual preceding nausea, making it distinct from other forms of vomiting that may have identifiable causes. It serves as a physiological response to protect the brain from further injury by attempting to alleviate the pressure.

In contrast, the other signs presented do not typically signify increased ICP in the context of a traumatic brain injury. A rash on the torso may suggest an allergic reaction or infection rather than a direct effect of increased pressure in the skull. Increased alertness would suggest a stable and functioning level of brain activity, which is not indicative of increased ICP. Excessive sleepiness can be a symptom of various conditions but is not specific to increased ICP and may be associated with other issues such as sedation or metabolic disturbances following injury.