In plan of care for craniotomy, which intervention should nurse include?

• A. Maintain seizure precautions
• B. Discontinue all IV fluids immediately
• C. Encourage strenuous activity
• D. Limit head-of-bed elevation

Answer: (A)

After craniotomy, seizures are a key safety risk because brain irritation and postoperative edema can provoke convulsions, which may increase intracranial pressure or injure the operative site. Implementing seizure precautions minimizes injury if a seizure occurs and helps protect the airway and neural tissue. This includes keeping the environment calm and quiet, padding side rails to prevent injury during convulsions, having suction and oxygen readily available, and administering antiseizure medications as ordered while monitoring for side effects. It’s also important to maintain proper head position and tubing management to support cerebral perfusion and airway patency. The other options don’t fit the post-craniotomy plan: abruptly stopping IV fluids can compromise hydration and brain perfusion; encouraging strenuous activity risks bleeding, increased ICP, and wound complications; and elevating the head of the bed beyond what’s prescribed or limiting elevation can hinder venous drainage and raise ICP.