Which of the following should NOT be included in the care plan for a client with increased intracranial pressure?

In the context of managing a client with increased intracranial pressure (ICP), certain interventions are critical to maintaining optimal conditions and preventing further complications. Coughing, in particular, should be avoided, as it can lead to a sudden increase in intrathoracic pressure, which may subsequently elevate intracranial pressure. This can exacerbate the client's condition and increase the risk of complications such as brain herniation.

Conversely, keeping the head elevated is a common practice in managing increased ICP, as it promotes venous drainage from the head, which can help reduce pressure. Administering prescribed medications such as osmotic diuretics or corticosteroids is also essential in managing ICP by reducing cerebral edema or altering the volume of cerebrospinal fluid. Allowing talking might not pose a direct threat to ICP, but it is advisable to monitor the patient’s responses to ensure that speaking does not lead to stress or strain that could affect their condition.

In summary, avoiding activities that might increase pressure inside the skull is crucial, and coughing is specifically a maneuver that could do so, making it an inappropriate choice for inclusion in the care plan.