A patient has intracranial pressure (ICP) monitoring with an intraventricular catheter. A priority nursing intervention is:

• A. Aseptic technique to prevent infection.
• B. Constant monitoring of ICP waveforms.
• C. Removal of CSF to maintain normal ICP.
• D. Sampling CSF to determine abnormalities.

Answer: (A)

Preventing infection is a priority because an intraventricular catheter provides a direct conduit into the brain and CSF. The most dangerous complication is ventriculitis or meningitis, which can lead to rapid neurologic deterioration, prolonged illness, and higher mortality. Therefore, strict aseptic technique must be maintained with every interaction involving the catheter—during insertion, dressing changes, maintaining the closed drainage system, and any CSF sampling or drain manipulations. This includes thorough hand hygiene, sterile gloves and equipment for access, and ensuring the system remains closed and well secured to prevent breaks in sterility.

While watching ICP waveforms, maintaining a sterile line, and performing CSF sampling are important parts of care, they do not prevent infection on their own. CSF removal or sampling should be done only as clinically indicated and with strict sterile technique to minimize infection risk.