Decreased adaptive capacity, intracranial: a proposal for a nursing diagnosis

A new nursing diagnosis is proposed related to failure of normal intracranial compensatory mechanisms manifested by repeated disproportional increases in ICP in response to noxious and nonnoxious stimuli. This diagnosis, decreased adaptive capacity--intracranial, occurs in patients with intracranial hypertension. It is not synonymous, however, with increased intracranial pressure (ICP). Rather, its use in the patient with intracranial hypertension allows the nurse to identify who is at high risk for disproportionate increase in ICP and decrease in cerebral perfusion pressure (CPP) secondary to ordinary activities of nursing care. The diagnosis can guide nursing management to reduce adaptive demands and increase adaptive capacity in those patients.