IGNOU PB Bsc Nsg Entrance-2017
Pharmacology
Medium
In head injury, Mannitol is given to?
Appeared in: IGNOU PB Bsc Nsg Entrance-2017
Explanation
- Mannitol is an osmotic diuretic, a primary medication used to manage cerebral edema and increased intracranial pressure (ICP) following a head injury.
- It works by increasing the osmotic pressure of the blood. This creates a gradient that pulls excess water from the swollen brain tissue back into the blood vessels.
- This reduction in brain tissue fluid (cerebral edema) directly lowers the pressure inside the skull, which is the main therapeutic goal.
- The kidneys then filter this excess fluid from the blood, resulting in a significant increase in urine output (diuresis).
Why Other Options Were Wrong
- Option A: Mannitol does not have anticonvulsant properties. It does not act on the neural pathways that cause seizures.
- Option B: Mannitol is not an analgesic (painkiller). While reducing ICP can secondarily relieve a headache caused by the pressure, it is not the primary agent for pain management.
- Option D: This is the opposite of Mannitol's effect. As a potent osmotic diuretic, it significantly increases urine output.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pharmacological management of increased intracranial pressure (ICP) in head injury helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses must administer Mannitol using an in-line filter because the solution can crystallize, especially at lower temperatures. These crystals can act as emboli if infused, causing serious complications.
- Continuous monitoring of urine output, serum osmolality, and electrolytes is critical. The goal is diuresis, but excessive fluid loss can lead to dehydration, hypotension, and electrolyte imbalances.
- What if? If a patient receiving Mannitol develops anuria (no urine output), the infusion must be stopped immediately and the physician notified. This indicates potential acute kidney injury, and continuing the drug could lead to fluid overload, pulmonary edema, and worsening renal failure.
How to Approach the Question
- First, identify the core of the question: the primary purpose of giving Mannitol in a head injury context.
- Recall the drug class of Mannitol. It is an osmotic diuretic.
- Connect the drug's class (osmotic diuretic) to the pathophysiology of head injury, which involves cerebral edema (swelling) and increased intracranial pressure (ICP).
- An osmotic diuretic works by pulling fluid from tissues. In the brain, this action reduces swelling and therefore lowers the dangerously high pressure inside the skull.
- Evaluate the options based on this mechanism. 'Decrease intracranial pressure' is the direct therapeutic goal. 'Increase urine output' is a consequence of the mechanism, not the primary goal for the brain. The other options relate to different drug classes (anticonvulsants and analgesics).
Concept Tested & Keywords
- Concept Tested: Pharmacological management of increased intracranial pressure (ICP) in head injury.
- Stem keywords: head injury, Mannitol
- Lead-in keywords: given to
- Negative lead-in flag: false
Question ID
QFVjGkIbv6EGzeQgkdzvt1
Reference Book
E6 Pharmacology Nursing Lilley 11e Part 2 p. 150-152
E6 Pharmacology Katzung 16e p. 415-417
E6 Medicine Harrison 22e Part 2 p. 249-251
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