Nursing management of Increased ICP — positioning is critical:

• Head of bed 30–45 degrees: Promotes venous drainage from the brain via jugular veins, reducing ICP
• Neutral neck alignment: Prevents jugular vein compression — neck flexion or rotation can obstruct venous outflow and raise ICP significantly

Actions to AVOID in IICP:

• Trendelenburg position (increases ICP)
• Valsalva maneuver (straining, coughing)
• Hip flexion > 90 degrees
• Clustering of nursing activities
• Hypercapnia (PaCO₂ > 45 mmHg causes cerebral vasodilation → increases ICP)

The Monro-Kellie doctrine states: ICP = Brain volume + Blood volume + CSF volume. Interventions target reducing any of these components.