Cushing's triad is seen in?

ISRO- 2016

Medical & Surgical Nursing

Easy

Appeared in: ISRO- 2016

Explanation

Cushing's triad is a set of three primary signs: hypertension with a widening pulse pressure, bradycardia, and irregular respirations.
This triad is a physiological response to severely increased intracranial pressure (ICP).
It is considered a late and ominous sign, indicating that the brain's compensatory mechanisms have failed and brainstem herniation is imminent.
The body raises blood pressure to perfuse the compressed brain, which in turn causes a reflex slowing of the heart rate, and pressure on the brainstem disrupts breathing.

Option A: Cushing's syndrome is an endocrine disorder caused by excess cortisol. While it features hypertension, it does not present with the specific triad of bradycardia and irregular respirations. Its signs include a moon face, buffalo hump, and central obesity.
Option B: Hypothyroidism (underactive thyroid) can cause bradycardia, but it is typically associated with hypotension or normal blood pressure, not the severe hypertension seen in Cushing's triad.
Option D: Hyperthermia (high body temperature or fever) typically causes tachycardia (a fast heart rate) and tachypnea (rapid breathing) as the body's metabolic demands increase. This is the opposite of the bradycardia and bradypnea seen in Cushing's triad.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of the clinical condition associated with Cushing's triad as background academic context rather than a clinical decision trigger.
Recognizing Cushing's triad is a critical nursing skill, as it signals a neurological emergency requiring immediate intervention to prevent irreversible brain damage or death from herniation.
A nurse observing these signs must immediately notify the physician or rapid response team, as urgent measures to reduce ICP (e.g., administering osmotic diuretics like mannitol, hyperventilation, or surgical decompression) are necessary.
What if? If a patient with a head injury develops a headache, nausea, and lethargy, but their vitals are stable, this represents an early sign of increasing ICP. The nurse's priority is to implement measures to prevent further ICP rise (e.g., elevating the head of the bed, maintaining a quiet environment) and perform frequent neurological assessments, rather than waiting for the late sign of Cushing's triad.

How to Approach the Question

First, identify the key term in the question: 'Cushing's triad'.
Recall the definition of Cushing's triad, which is a specific set of three vital sign changes.
Remember that this triad is a critical sign related to a specific organ system.
Evaluate the options to determine which condition causes this neurological response.
Differentiate Cushing's triad (a neurological sign of increased ICP) from the similarly named Cushing's syndrome (an endocrine disorder).

Concept Tested & Keywords

Concept Tested: Identification of the clinical condition associated with Cushing's triad.
Stem keywords: Cushing's triad
Lead-in keywords: seen in
Negative lead-in flag: false

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