Saunders Neurological Practice Test

In aneurysm precautions, anything that raises intracranial pressure should be avoided. Coughing significantly increases intrathoracic pressure, which is transmitted to the cerebral venous system and raises intracranial pressure. A sudden or repeated rise in ICP can threaten an aneurysm by promoting rebleeding or rupture, so encouraging hourly coughing is the action to avoid.

In contrast, incentive spirometry and deep breathing promote gradual, controlled ventilation and help prevent atelectasis without causing abrupt spikes in ICP. Repositioning patients gently side to side every couple of hours supports airway clearance and oxygenation while staying mindful of avoiding maneuvers that abruptly raise ICP.