Nursing Interventions: Cerebral Aneurysm

1. Establish and maintain a patent airway as needed.
2. Administer supplemental oxygen as ordered.
3. Position the patient to promote pulmonary drainage and prevent upper airway obstruction.
4. Avoid placing the patient in the prone position as well as hyperextending his neck.
5. Suction secretions from the airway as necessary to prevent hypoxia and vasodilation from carbon dioxide accumulation.
6. Monitor pulse oximetry levels and arterial blood gas level as ordered. Use these levels as a guide to determine appropriate needs for supplemental oxygen.
7. Prepare the patient for emergency craniotomy, if indicated.
8. If surgery can’t be performed immediately, institute aneurysm precautions to minimize the risk of rebleeding and to avoid increasing the patient’s intracranial pressure.
9. Administer hydralazine or another antihypertensive agent as ordered.
10. Turn the patient often. Encourage deep breathing and leg movement.
11. Apply elastic stockings or compression boots to the patient’s legs to reduce the risk of deep vein thrombosis.
12. Give fluids as ordered and monitor I.V. infusions to avoid overhydration, which may increase ICP.
13. If the patient has facial weakness, assist him during meals; assess his gag reflex and place the food in the unaffected side of his mouth.
14. Implement a bowel elimination program based on previous habits.
15. Raise the bed’s side rails to protect the patient from injury.
16. Provide emotional support to the patient and his family.