Post-craniotomy nursing, what should be the primary focus to prevent complications?

• A. Pain control
• B. Preventing infection
• C. Preventing increased ICP and infection
• D. Early discharge

Answer: (C)

After craniotomy, the brain is especially vulnerable to swelling and infection, and these threats drive the most important nursing priorities. Elevations in intracranial pressure from edema, hematoma, or impaired CSF flow can rapidly reduce cerebral perfusion and lead to brain herniation, making preventing increased ICP the primary focus. At the same time, surgical wounds and implanted devices are susceptible to infection, which can cause meningitis, abscess, or wound complications and seriously worsen outcomes. So the main goal is to prevent both ICP rise and infection through careful neuro assessment, head positioning, avoiding actions that raise ICP, maintaining airway and oxygenation, ensuring meticulous aseptic wound care, and adhering to antibiotic prophylaxis as ordered. Pain management matters and can help prevent agitation or coughing that might raise ICP, but it’s not the top priority for preventing the most dangerous complications. Early discharge would deprive the patient of needed monitoring for ICP changes and infection.