What critical indicators should a nurse monitor in a client with increased intracranial pressure?

Monitoring systolic blood pressure and cerebral perfusion pressure is essential in a client with increased intracranial pressure (ICP) because both are critical for assessing the adequacy of cerebral blood flow. Increased ICP can lead to cerebral ischemia, and maintaining adequate perfusion pressure is crucial to ensuring that the brain receives sufficient oxygen and nutrients.

Systolic blood pressure provides information regarding the overall systemic circulation and can reflect the body's ability to maintain cerebral perfusion despite elevated pressures within the cranial cavity. Cerebral perfusion pressure (CPP) is calculated by subtracting intracranial pressure from mean arterial pressure and is a direct measure of the pressure available to maintain cerebral blood flow. A CPP that falls below critical thresholds indicates risk for brain injury due to inadequate blood flow.

Monitoring these two indicators allows for timely interventions, such as medication adjustments or surgical interventions, to prevent further neurological compromise in clients suffering from conditions that increase ICP, such as traumatic brain injury, hemorrhagic strokes, or brain tumors.