Which sign should a nurse monitor in an infant to identify increased intracranial pressure?

In infants, identifying signs of increased intracranial pressure (ICP) is crucial for early intervention. One significant indicator to monitor is changes in sleeping patterns. When an infant experiences increased ICP, they may exhibit altered levels of responsiveness, which can manifest as increased sleepiness or lethargy. This change occurs because the brain may respond to increased pressure by slowing down overall activity levels, including wakefulness.

Increased sleeping is a critical sign that the body might be redirecting energy due to the stress of managing elevated pressures within the cranial cavity. The infant may seem more difficult to wake or may sleep for extended periods, which can indicate a need for further evaluation and monitoring.

Observing signs like decreased appetite or excessive crying can be useful in certain contexts but may not be as specifically linked to increased ICP in infants compared to changes in sleep. Hyperactivity, on the other hand, is contrary to what one might expect with increased ICP, as altered mental status and reduced stimulation often accompany such a condition. Thus, monitoring for increased sleeping is a vital step in assessing potential increases in intracranial pressure in infants.