A client has a head injury and is brought to the emergency department. The vital signs are P: 78; R: 16; B/P: 120/80. The change in this client’s vital signs that indicates increasing intracranial pressure (ICP) requiring notification of the practitioner is:

Choice A reason: Increasing ICP causes Cushing’s triad: bradycardia (P: 50), irregular respirations (R: 22), and widened pulse pressure (B/P: 140/60). These indicate brain compression, requiring immediate notification, making this the correct vital sign change. Choice B reason: A pulse of 56 and B/P of 130/110 show hypertension but not widened pulse pressure. Respirations are mildly elevated, not irregular, making this less indicative of ICP than Cushing’s triad. Choice C reason: P: 60, R: 18, and B/P: 126/96 are near normal, not reflecting Cushing’s triad. These changes are subtle and less concerning for acute ICP elevation, making this incorrect. Choice D reason: P: 120 and B/P: 80/60 suggest shock, not ICP. Tachycardia and hypotension are opposite to Cushing’s triad, making this incorrect for indicating increasing intracranial pressure.