Which vital-sign pattern is associated with increased ICP?

Which vital-sign pattern is associated with increased ICP?

• A. Increased heart rate with narrowed pulse pressure
• B. Tachycardia with widened pulse pressure
• C. Bradycardia with widened pulse pressure
• D. Hyperthermia with tachycardia

Answer: (C)

Increased ICP often produces the Cushing reflex, a dangerous pattern of vital signs. The hallmark is bradycardia with a widened pulse pressure (a larger difference between systolic and diastolic blood pressures). Mechanistically, rising ICP reduces cerebral perfusion, so the body responds by increasing systemic blood pressure to force blood through the cramped vessels. This results in higher systolic pressures, and the baroreceptor reflex slows the heart, causing a slower heart rate. The combination of a high, widened pulse pressure and bradycardia is the classic sign of rising ICP (often with irregular respirations as brainstem involvement progresses). Other patterns—like tachycardia with widened or narrowed pulse pressure or hyperthermia with tachycardia—don’t reflect this brainstem-mediated response to increased ICP.

Increased ICP often produces the Cushing reflex, a dangerous pattern of vital signs. The hallmark is bradycardia with a widened pulse pressure (a larger difference between systolic and diastolic blood pressures). Mechanistically, rising ICP reduces cerebral perfusion, so the body responds by increasing systemic blood pressure to force blood through the cramped vessels. This results in higher systolic pressures, and the baroreceptor reflex slows the heart, causing a slower heart rate. The combination of a high, widened pulse pressure and bradycardia is the classic sign of rising ICP (often with irregular respirations as brainstem involvement progresses). Other patterns—like tachycardia with widened or narrowed pulse pressure or hyperthermia with tachycardia—don’t reflect this brainstem-mediated response to increased ICP.