Cushing's triad is a late sign of increased intracranial pressure and includes which combination of changes?

• A. Systolic pressure drops, diastolic increases, tachycardia
• B. Temperature decreases with bradycardia
• C. Systolic pressure increases, diastolic pressure decreases, pulse slows, respirations slow
• D. Rapid breathing with narrowed pulse pressure

Answer: (C)

Cushing's triad is a late sign of increased intracranial pressure, reflecting the body's attempt to preserve cerebral perfusion while the brainstem becomes compressed. The hallmark pattern is hypertension with a widened pulse pressure (systolic pressure rises while diastolic pressure falls or stays low), along with bradycardia and irregular or slowed respirations. The increased systolic pressure helps push blood into the brain when ICP is high, the diastolic pressure drops or remains low, widening the pulse pressure, and the slower heart rate results from baroreceptor reflexes to the elevated blood pressure. Brainstem compression disrupts respiratory centers, producing irregular and often slowed breathing. The option describing higher systolic pressure, lower diastolic pressure, slower pulse, and slower respirations best fits this triad. Other choices describe patterns not aligned with Cushing's triad, such as tachycardia, hypothermia, rapid breathing, or narrow pulse pressure.