— 生理適應 · HARD · SATA —
下列哪些評估發現暗示顱內壓（ICP）升高？（選所有適合的）
Which assessment findings are indicative of increased intracranial pressure (ICP)? (Select all that apply.)
- ABradycardia✓ 正解心搏過慢
- BIrregular respirations✓ 正解呼吸不規則
- CWidening pulse pressure✓ 正解脈壓差變寬
- DTachycardia心搏過速
- EProjectile vomiting✓ 正解噴射性嘔吐
— Explanation · 中文詳解 —
庫欣氏三徵（Cushing's triad）包括心跳過慢、呼吸不規則及收縮壓上升（導致脈壓變大），為 ICP 升高的晚期跡象。噴射狀嘔吐亦是顱內壓升高的常見臨床表現。心跳過速（Tachycardia）通常與休克或疼痛相關，非 ICP 升高表現。
Increased intracranial pressure (ICP) is indicated by Cushing's triad, which includes bradycardia, irregular respirations, and widening pulse pressure. Projectile vomiting is also a common sign resulting from stimulation of the emetic center by elevated pressure. These findings reflect brainstem compression and require immediate intervention.
✦ 台美臨床差異
兩者對於 ICP 監測指標的臨床解讀一致，但在 ICU 護理常規中，台灣對 EVD 壓力監測的介入較由外科醫師主導。