A patient with head injury has BP 92/50 and ICP 18; which action is appropriate?

• A. Notify the health care provider about the assessments.
• B. Elevate the head of the patient's bed.
• C. Check the patient's pupillary response to light.
• D. Document and continue to monitor the parameters.

Answer: (D)

The main idea being tested is how to interpret intracranial pressure with concurrent systemic blood pressure and how to act when values are outside the normal range without immediate, clear-cut intervention orders. In this scenario, the reading shows mildly elevated ICP and hypotension. Documenting and continuing to monitor the parameters is the best single action because it establishes a trend and informs whether further escalation is needed. Immediate measures like elevating the head of the bed could potentially worsen cerebral perfusion in a hypotensive patient, since raising the head can lower mean arterial pressure and further reduce cerebral perfusion pressure. Checking pupillary response is important for ongoing neuro assessment, but it doesn’t address the perfusion issue. Notifying the provider is essential if values worsen or fail to improve, but the most appropriate immediate step among the options is to document the current readings and keep monitoring to detect a changing trajectory. If CPP remains low or ICP rises, intervention plans would follow based on provider orders.