Progressive Care Nursing Certification (PCCN) Practice Exam

What vital sign change is characteristic of increased intracranial pressure?

1. Widened pulse pressure

2. Increased respiratory rate

3. Decreased heart rate

4. Lowered blood pressure

The correct answer is: Widened pulse pressure

Widened pulse pressure is indeed characteristic of increased intracranial pressure (ICP). This phenomenon occurs due to the body's compensatory mechanisms in response to the elevated pressure within the skull. As intracranial pressure rises, it can impact cerebral perfusion, leading to alterations in blood flow dynamics. A widened pulse pressure typically indicates that there is an increase in the difference between the systolic and diastolic blood pressure readings. This situation arises as systemic blood pressure may increase (due to the body's attempt to ensure adequate cerebral perfusion) while diastolic pressure may remain stable or decrease. The underlying pathophysiology involves the body's attempt to maintain cerebral perfusion pressure despite the constraining factor of elevated ICP. Understanding this concept is critical for recognizing signs of increased ICP and potential complications that can arise in patients with neurological issues. The connection between widened pulse pressure and increased ICP underscores the importance of monitoring vital signs in progressive care settings.