When caring for a client with increased ICP, what position is most appropriate for the nurse to maintain?

Maintaining an elevated head position is the most appropriate for a client with increased intracranial pressure (ICP) due to its beneficial effects on venous drainage from the brain. Elevating the head of the bed typically to an angle of 30 to 45 degrees helps to facilitate the return of venous blood from the head, thereby potentially reducing the pressure within the cranial cavity. This position promotes better cerebral perfusion by lowering the pressure gradient against which the heart must pump to maintain blood flow, making it essential in managing conditions with elevated ICP.

Additionally, the elevated position can help to prevent complications such as increased pressure due to pooling of blood and can assist in maintaining airway patency, particularly in cases where neuromonitoring or management of airway secretions is necessary. Coach clinicians may encourage the patient to avoid being flat, which could increase ICP, and similar reasoning applies against positions like Trendelenburg, which could inadvertently elevate central venous pressure and worsen cerebral edema.