In caring for a client post-CVA during the first 72 hours, what should the nurse do to prevent an increase in ICP?

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Erecting the head of the bed (HOB) to 25-30 degrees with neutral positioning is a clinically sound approach for managing a patient after a cerebrovascular accident (CVA), particularly during the critical first 72 hours post-event. This position helps facilitate venous drainage from the brain, thereby reducing intracranial pressure (ICP).

When the head of the bed is elevated to this angle, it allows for improved cerebral perfusion while also decreasing the risk of complications associated with increased ICP, such as further neurological decline or long-term sequelae. Maintaining a neutral neck position is equally important, as flexion or extension can impede venous outflow and contribute to elevated ICP.

Positioning the client correctly post-CVA is crucial to promote safety and recovery. Furthermore, it is widely recognized that elevating the head of the bed can facilitate optimal respiratory function and reduce the likelihood of aspiration, which are vital considerations in the post-stroke care plan.

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