Which symptoms should a nurse assess in an infant for signs of increased intracranial pressure (ICP)?

A bulging fontanel is a significant indicator of increased intracranial pressure (ICP) in infants. The fontanels are the soft spots on an infant's skull where the bones have not yet fused together. When there is an increase in the pressure within the skull, it can cause the fontanel to bulge outward due to the pressure exerted by the cerebrospinal fluid and swelling of the brain. This physical change is observable and can alert healthcare providers to potential complications requiring further investigation and intervention.

While emesis can occur with increased ICP due to increased pressure on the brain or irritation of the vomiting center, it is not as definitive an indicator as a bulging fontanel, which is specifically related to the structure of an infant's skull. Headaches are common in older children and adults but are often difficult to assess in infants, as they cannot verbalize their discomfort. Mood swings are also not a typical assessment finding in infants relating to ICP and are more subjective, making them less reliable when assessing for increased intracranial pressure.