下列哪些護理措施適用於顱內壓 (ICP) 增高的病人？（選所有適合的）
Which nursing interventions are appropriate for a client with increased intracranial pressure (ICP)? (Select all that apply.)
- AElevate the head of the bed to 30 degrees✓ 正解將床頭抬高 30 度
- BMaintain the head in a neutral midline position✓ 正解維持頭部中立正中位置
- CPerform clustering of care activities集中執行護理活動
- DHyperventilate the client as needed必要時使病人過度換氣
- EAdminister stool softeners✓ 正解給予糞便軟化劑
降低 ICP 的原則為促進靜脈回流（頭抬高、中線姿勢）及避免腹壓增加（軟便劑）。抬頭 30 度與頭部中線姿勢能降低顱內靜脈淤滯。Clustering care（將護理活動集中在短時間內執行）會導致 ICP 突然升高，應避免。過度換氣則僅在緊急狀況下才使用，非日常護理措施。軟便劑能避免便秘導致腹壓增加，進而影響顱內壓。
The principles for reducing ICP are promoting venous return (head elevation and midline positioning) and avoiding increases in intra-abdominal pressure (stool softeners). Elevating the head of the bed to 30 degrees and keeping the head in a neutral midline position decrease intracranial venous stasis. Clustering nursing activities into a short period can cause abrupt rises in ICP and should be avoided. Hyperventilation is only used in emergency situations and is not part of routine care. Stool softeners prevent constipation, which would otherwise raise intra-abdominal pressure and, in turn, ICP.