In suspected cerebral aneurysm, which initial nursing action is appropriate?

• A. Elevate head of bed to 30 degrees.
• B. Administer a benzodiazepine.
• C. Increase IV fluids to 2 L/hr.
• D. Call for surgical clipping immediately.

Answer: (A)

When a suspected cerebral aneurysm is present, the priority is to minimize rises in intracranial pressure and support brain perfusion. Elevating the head of the bed to 30 degrees helps by promoting venous drainage from the brain, which reduces ICP and can improve cerebral perfusion. This simple positioning acts as an immediate stabilizing measure while assessment and further treatment are planned, and it also helps keep the head and neck in a neutral position to avoid additional obstruction of venous outflow.

Administering a benzodiazepine might be used for agitation or seizures, but it doesn’t directly address ICP and isn’t the first action taken for stabilization. Increasing IV fluids to a high rate can raise ICP and worsen edema, so that choice isn’t appropriate as an initial step. Calling for surgical clipping immediately is an important part of definitive management, but it isn’t an initial nursing action before imaging, diagnosis, and stabilization have occurred.