Progressive Care Nursing Certification (PCCN) Practice Exam

How does blood pressure typically respond to increasing intracranial pressure (ICP)?

1. Only systolic blood pressure will increase

2. Only diastolic blood pressure will increase

3. Systolic blood pressure will increase with a decrease in diastolic blood pressure

4. The pulse pressure will narrow

The correct answer is: Systolic blood pressure will increase with a decrease in diastolic blood pressure

Increasing intracranial pressure (ICP) typically leads to changes in blood pressure as part of the body's compensatory mechanisms. When ICP rises, the brain's autoregulatory mechanisms are triggered, often resulting in an increase in systolic blood pressure to ensure adequate cerebral perfusion. However, this increased systolic pressure can occur alongside a decrease in diastolic pressure, leading to a widening gap between these two pressure measurements. As a result, the net effect is that the pulse pressure—the difference between systolic and diastolic blood pressure—widens initially. However, progressive increases in ICP might lead to a situation where the diastolic pressure fails to rise adequately, leading to the phenomenon observed in the correct response. In this situation, although systolic blood pressure increases significantly, diastolic blood pressure may not keep pace, causing the overall perfusion status to become compromised over time. This understanding is crucial in the management of patients with increased ICP, as it helps guide therapeutic interventions aimed at maintaining sufficient cerebral blood flow and preventing further complications. Monitoring blood pressure patterns can also serve as an important indicator of the situation in the cranial cavity.