護理師照護一位頭部創傷病人，下列哪項護理措施禁用於預防顱內壓升高？
A nurse is caring for a client with a traumatic brain injury. Which nursing action is contraindicated in preventing increased intracranial pressure (ICP)?
- AEncouraging the client to perform deep coughing✓ 正解鼓勵病人進行深層咳嗽
- BElevating the head of the bed to 30 degrees將床頭抬高 30 度
- CAdministering stool softeners給予軟便劑
- DMaintaining a calm, quiet environment維持安靜平和的環境
顱內壓升高（Increased ICP）的預防關鍵在於減少顱內壓力源。任何會引發 Valsalva 效應的動作（如用力排便、咳嗽、搬重物）都會導致胸內壓升高，進而阻礙腦部靜脈回流，使顱內壓急劇上升。因此，頭部創傷病人應避免深呼吸後用力咳嗽，並給予軟便劑預防便秘。抬高床頭 30 度有助於靜脈回流，是正確的護理措施。保持環境安靜可減少交感神經刺激，降低腦代謝需求。
The key to preventing increased intracranial pressure (ICP) is to reduce intracranial pressure sources. Any maneuver that triggers a Valsalva effect (such as straining at stool, coughing, or lifting heavy objects) raises intrathoracic pressure, impedes cerebral venous return, and sharply raises ICP. Therefore, patients with head injuries should avoid deep breathing followed by forceful coughing, and stool softeners should be given to prevent constipation. Elevating the head of the bed to 30 degrees promotes venous return and is a correct nursing measure. Keeping the environment quiet reduces sympathetic stimulation and lowers cerebral metabolic demand.