Which option indicates a sign of Cushing's triad?

• A. Kussmaul respirations
• B. Heart rate decreases from 75 to 55 beats per minute
• C. Temperature over 100.4° F (38° C)
• D. Heart rate increases from 90 to 110 beats per minute

Answer: (B)

Elevated intracranial pressure can produce Cushing's triad, a late warning sign of brain herniation risk. This triad consists of hypertension with a wide pulse pressure, bradycardia, and irregular respirations. A heart rate dropping from 75 to 55 bpm is bradycardia, which is the cardiovascular component of the triad and indicates the ICP is rising. The other options don’t fit: Kussmaul respirations point to metabolic acidosis, fever is not part of the triad, and a heart rate that increases would be tachycardia, not the bradycardia seen in Cushing’s triad.