A nurse is educating a student about cerebral edema.
The student nurse inquires, “What type of cerebral edema is associated with a patient who has had a stroke?” Which of the following is the best response from the nurse?

Choice A rationale
Cushing’s Triad, which includes bradycardia (low heart rate), irregular respiration, and widened pulse pressure, is a nervous system response that could prevent brainstem ischemia. Brainstem ischemia is a condition where there is insufficient blood flow to the brainstem, which can lead to cell death.
Choice B rationale

While tachycardia (high heart rate) is a serious condition, it is not typically prevented by Cushing’s Triad.
Choice C rationale
Agonal breathing, which is characterized by gasping, labored breathing, particularly when lying flat, is not typically prevented by Cushing’s Triad.
Choice D rationale
Chest pain is not typically prevented by Cushing’s Triad. Cushing’s Triad is a response to increased intracranial pressure, not a cardiac condition.

Choice A rationale
Rebleeding of the injury is a significant factor related to a high mortality rate for a client who has a subarachnoid hemorrhage (SAH). SAH is a devastating event with substantial mortality and high morbidity among survivors. The most common primary causes of death or neurological devastation leading to withdrawal of support are direct effects of the primary hemorrhage (55%) and aneurysm rebleeding (17%)2. Therefore, rebleeding of the injury is a critical concern in the management of SAH.
Choice B rationale
Decreased cerebrospinal fluid is not directly linked to a high mortality rate in SAH. While changes in cerebrospinal fluid dynamics can occur after SAH, it’s not typically a primary factor contributing to mortality.
Choice C rationale
The use of nimodipine is actually part of the treatment protocol for SAH. Nimodipine is a calcium channel blocker that is used to prevent cerebral vasospasm, a complication of SAH. It does not contribute to a higher mortality rate.
Choice D rationale
Poor functional ability could be a result of SAH due to neurological damage, but it is not a direct cause of high mortality. The severity of the initial hemorrhage and subsequent

complications like rebleeding or medical complications are more directly tied to mortality rates.