Which of the following respiratory patterns indicate increasing icp in the brain stem?

  • 1.

    Arnold, W. H., Jr., and & Grant, J. L.Oxygen-induced hypoventilation.Am. Rev. resp. Dis., 1967, 95:255261.Arnold, W. H., Jr., and Grant, J. L. Oxygen-induced hypoventilation. Am. Rev. resp. Dis., 1967, 95:255–261.

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  • 2.

    Bernards, J. A., , DeJours, D. & Lacaisse, A.Ventilatory effects in man of breathing successively CO2 -free, CO2-enriched, and CO2-free gas mixtures with low, normal or high oxygen concentration.Resp. Physiol., 1966, 1:390397.Bernards, J. A., DeJours, D., and Lacaisse, A. Ventilatory effects in man of breathing successively CO2 -free, CO2-enriched, and CO2-free gas mixtures with low, normal or high oxygen concentration. Resp. Physiol., 1966, 1:390–397.

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  • 3.

    Brown, H. W. & Plum, F.Neurologic basis of Cheyne-Stokes respiration.Am. J. Med., 1961, 30:849860.Brown, H. W., and Plum, F. Neurologic basis of Cheyne-Stokes respiration. Am. J. Med., 1961, 30:849–860.

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  • 4.

    Brown, J. H. V.Failure of the respiratory response to low oxygen tension.J. Aviat. Med., 1956, 27:460461.Brown, J. H. V. Failure of the respiratory response to low oxygen tension. J. Aviat. Med., 1956, 27:460–461.

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  • 5.

    Cook, A. W., , Browder, E. J. & Lyons, H. A.Alterations in acid-base equilibrium in craniocerebral trauma: a determinant in survival.J. Neurosurg., 1961, 18:366370.Cook, A. W., Browder, E. J., and Lyons, H. A. Alterations in acid-base equilibrium in craniocerebral trauma: a determinant in survival. J. Neurosurg., 1961, 18:366–370.

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  • 6.

    Cormack, R. S., , Cunningham, D. J. C. & Gee, J. B. L.The effect of carbon dioxide on the respiratory response to want of oxygen in man.Q. Jl exp. Physiol., 1957, 42:303319.Cormack, R. S., Cunningham, D. J. C., and Gee, J. B. L. The effect of carbon dioxide on the respiratory response to want of oxygen in man. Q. Jl exp. Physiol., 1957, 42:303–319.

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  • 7.

    Davies, R. O. & Yamamoto, W. S.Synchronization of hyperventilation with stimulus frequency.Resp. Physiol., 1966, 1:4157.Davies, R. O., and Yamamoto, W. S. Synchronization of hyperventilation with stimulus frequency. Resp. Physiol., 1966, 1:41–57.

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  • 8.

    DeJours, P., , Labrousse, Y., , Raynaud, J. & Teillac, A.Stimulus oxygène chemoreflexe de la ventilation à basse altitude (50m) chez l'homme. I. Au repos.J. Physiol., Paris, 1957, 49:115120.DeJours, P., Labrousse, Y., Raynaud, J., and Teillac, A. Stimulus oxygène chemoreflexe de la ventilation à basse altitude (50m) chez l'homme. I. Au repos. J. Physiol., Paris, 1957, 49:115–120.

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  • 9.

    DeJours, P., , Labrousse, Y., , Raynaud, J., , Girard, F. & Teillac, A.Stimulus oxygène de la ventilation au repos et au cours de l'exercice musculaire, à basse altitude (50m), chez l'homme.Revue fr. Etud. clin. biol., 1958, 3:105123.DeJours, P., Labrousse, Y., Raynaud, J., Girard, F., and Teillac, A. Stimulus oxygène de la ventilation au repos et au cours de l'exercice musculaire, à basse altitude (50m), chez l'homme. Revue fr. Etud. clin. biol., 1958, 3:105–123.

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  • 10.

    Dripps, R. D. & Comroe, J. H., Jr.The effect of the inhalation of high and low oxygen concentrations on respiration, pulse rate, ballistocardiogram and arterial oxygen saturation (oximeter) of normal individuals.Am J. Physiol., 1947, 149:277291.Dripps, R. D., and Comroe, J. H., Jr. The effect of the inhalation of high and low oxygen concentrations on respiration, pulse rate, ballistocardiogram and arterial oxygen saturation (oximeter) of normal individuals. Am J. Physiol., 1947, 149:277–291.

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  • 11.

    Fencl, V., , Miller, T. B. & Pappenheimer, J. R.Studies on the respiratory response to disturbances of acid-base balance, with deductions concerning the ionic composition of cerebral interstitial fluid.Am. J. Physiol., 1966, 210:459472.Fencl, V., Miller, T. B., and Pappenheimer, J. R. Studies on the respiratory response to disturbances of acid-base balance, with deductions concerning the ionic composition of cerebral interstitial fluid. Am. J. Physiol., 1966, 210:459–472.

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  • 12.

    Fenn, W. O. & Rahn, H.Respiration. In: Handbook of physiology (Section III.)Field, J., Ed., Washington, D. C.: American Physiological Society, 1965, (See Vol. I:1926, and Vol. II:9271696.) Fenn, W. O., and Rahn, H. Respiration. In: Handbook of physiology (Section III.) Field, J., Ed., Washington, D. C.: American Physiological Society, 1965, 2 Vols. (See Vol. I:1–926, and Vol. II:927–1696.)

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  • 13.

    Fink, B. R., , Katz, R., , Reinhold, H. & Schoolman, A.Suprapontine mechanisms in regulation of respiration.Am. J. Physiol., 1962, 202:217220.Fink, B. R., Katz, R., Reinhold, H., and Schoolman, A. Suprapontine mechanisms in regulation of respiration. Am. J. Physiol., 1962, 202:217–220.

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  • 14.

    Garlind, T. & Linderholm, H.Hypoventilation syndrome in a case of chronic epidemic encephalitis.Acta med. scand., 1958, 162:333349.Garlind, T., and Linderholm, H. Hypoventilation syndrome in a case of chronic epidemic encephalitis. Acta med. scand., 1958, 162:333–349.

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  • 15.

    Green, H. D. & Denison, A. B.Absence of vasomotor responses to epinephrine and arterenol in an isolated intracranial circulation.Circulation Res., 1956, 4:565573.Green, H. D., and Denison, A. B. Absence of vasomotor responses to epinephrine and arterenol in an isolated intracranial circulation. Circulation Res., 1956, 4:565–573.

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  • 16.

    Haggendal, E. & Johansson, B.Effects of arterial carbon dioxide tension and oxygen saturation on cerebral blood flow autoregulation in dogs.Acta physiol. scand., 1966, (Suppl. 258)66:2753.Haggendal, E., and Johansson, B. Effects of arterial carbon dioxide tension and oxygen saturation on cerebral blood flow autoregulation in dogs. Acta physiol. scand., 1966, (Suppl. 258) 66:27–53.

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  • 17.

    Honda, Y., , Natsui, T., , Hasumura, N. & Nakamura, K.Threshold PCO2 for respiratory system in acute hypoxia of dogs.J. appl. Physiol., 1963, 18:10531056.Honda, Y., Natsui, T., Hasumura, N., and Nakamura, K. Threshold PCO2 for respiratory system in acute hypoxia of dogs. J. appl. Physiol., 1963, 18:1053–1056.

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  • 18.

    Huang, C. T., , Cook, A. W. & Lyons, H. A.Severe craniocerebral trauma and respiratory abnormalities. I. Physiological studies with specific reference to effect of tracheostomy on survival.Archs Neurol., Chicago, 1963, 9:545554.Huang, C. T., Cook, A. W., and Lyons, H. A. Severe craniocerebral trauma and respiratory abnormalities. I. Physiological studies with specific reference to effect of tracheostomy on survival. Archs Neurol., Chicago, 1963, 9:545–554.

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  • 19.

    Ishii, S., , Tsuji, H., , Ozawa, K., , Kondo, Y. & Evans, J. P.Brain edema. In: Brain edema.Klatzo, I., and & Seitelberger, F., Eds., New York: Springer-Verlag, 1967, (See pp. 3266.) Ishii, S., Tsuji, H., Ozawa, K., Kondo, Y., and Evans, J. P. Brain edema. In: Brain edema. Klatzo, I., and Seitelberger, F., Eds., New York: Springer-Verlag, 1967, 704 pp. (See pp. 32–66.)

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  • 20.

    Ishii, S.Brain swelling: studies of structural, physiologic and biochemical alterations. In: Head injury. Caveness, W. F., and & Walker, A. E., Eds., Philadelphia: J. B. Lippincott Co., 1966, (See pp. 276299.) Ishii, S. Brain swelling: studies of structural, physiologic and biochemical alterations. In: Head injury. Caveness, W. F., and Walker, A. E., Eds., Philadelphia: J. B. Lippincott Co., 1966, 589 pp. (See pp. 276–299.)

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  • 21.

    Katz, R. L. & Ngai, S. H.Respiratory effects of diethyl ether in the cat. J. Pharmac. exp. ther., 1962, 138:329336.Katz, R. L., and Ngai, S. H. Respiratory effects of diethyl ether in the cat. J. Pharmac. exp. ther., 1962, 138:329–336.

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  • 22.

    Kety, S. S., , Polis, B. D., , Nadler, C. S. & Schmidt, C. F.The blood flow and oxygen consumption of the human brain in diabetic acidosis and coma.J. clin. Invest., 1948, 27:500510.Kety, S. S., Polis, B. D., Nadler, C. S., and Schmidt, C. F. The blood flow and oxygen consumption of the human brain in diabetic acidosis and coma. J. clin. Invest., 1948, 27:500–510.

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  • 23.

    Lambertsen, C. J., , Wollman, H. & Gelfand, R.The dynamics of change in respiration and arterial blood and CSF acid base parameters during administration and with-drawal of CO2.Fedn Proc. Fedn Am. Socs exp. Biol., 1961, 20:430. Lambertsen, C. J., Wollman, H., and Gelfand, R. The dynamics of change in respiration and arterial blood and CSF acid base parameters during administration and with-drawal of CO2. Fedn Proc. Fedn Am. Socs exp. Biol., 1961, 20:430.

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  • 24.

    Langfitt, T. W., , Kassell, N. F. & Weinstein, J. D. Cerebral blood flow with intracranial hypertension.Neurology, Minneap., 1965, 15:761773.Langfitt, T. W., Kassell, N. F., and Weinstein, J. D. Cerebral blood flow with intracranial hypertension. Neurology, Minneap., 1965, 15:761–773.

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  • 25.

    Langfitt, T. W., , Tannanbaum, H. M. & Kassell, N. F.The etiology of acute brain swelling following experimental head injury.J. Neurosurg., 1966, 24:4756.Langfitt, T. W., Tannanbaum, H. M., and Kassell, N. F. The etiology of acute brain swelling following experimental head injury. J. Neurosurg., 1966, 24:47–56.

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  • 26.

    Langfitt, T. W., , Weinstein, J. D. & Kassell, N. F.Cerebral vasomotor paralysis produced by intracranial hypertension.Neurology, Minneap., 1965, 15:622641.Langfitt, T. W., Weinstein, J. D., and Kassell, N. F. Cerebral vasomotor paralysis produced by intracranial hypertension. Neurology, Minneap., 1965, 15:622–641.

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  • 27.

    Langfitt, T. W., , Weinstein, J. D. & Kassell, N. F.Vascular factors in head injury. In: Head injury. Caveness, W. F., and & Walker, A. E., Eds., Philadelphia: J. Lippincott Co., 1966, (See pp. 172194.) Langfitt, T. W., Weinstein, J. D., and Kassell, N. F. Vascular factors in head injury. In: Head injury. Caveness, W. F., and Walker, A. E., Eds., Philadelphia: J. Lippincott Co., 1966, 589 pp. (See pp. 172–194.)

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  • 28.

    Lundberg, N.Continuous recording and control of ventricular fluid pressure in neurosurgical practice.Acta psychiat. neurol. scand., 1960(Suppl. 149), 36:1193.Lundberg, N. Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta psychiat. neurol. scand., 1960 (Suppl. 149), 36:1–193.

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  • 29.

    Lundberg, N., , Kjällquist, A. & Bien, C.Reduction of increased intracranial pressure by hyperventilation. A therapeutic aid in neurological surgery.Acta psychiat. neurol. scand., 1959(Suppl. 139), 34:164.Lundberg, N., Kjällquist, A., and Bien, C. Reduction of increased intracranial pressure by hyperventilation. A therapeutic aid in neurological surgery. Acta psychiat. neurol. scand., 1959 (Suppl. 139), 34:1–64.

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  • 30.

    Lundberg, N., , Troupp, H. & Lorin, H. Continuous recording of the ventricular-fluid pressure in patients with severe acute traumatic brain injury: a preliminary report.J. Neurosurg., 1965, 22:581590.Lundberg, N., Troupp, H., and Lorin, H. Continuous recording of the ventricular-fluid pressure in patients with severe acute traumatic brain injury: a preliminary report. J. Neurosurg., 1965, 22:581–590.

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  • 31.

    MacIver, I. N., , Frew, I. J. C., & Matheson, J. G.The role of respiratory insufficiency in the mortality of severe head injuries.Lancet, 1958, 1:390393.MacIver, I. N., Frew, I. J. C., Matheson, J. G. The role of respiratory insufficiency in the mortality of severe head injuries. Lancet, 1958, 1:390–393.

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  • 32.

    Milic-Emili, G., , Raynaud, J. & DeJours, P.Etude critique d'une méthode de mise en évidence du stimulus oxygène ventilatoire chez l'homme.J. Physiol., Paris, 1960, 52:177178.Milic-Emili, G., Raynaud, J., and DeJours, P. Etude critique d'une méthode de mise en évidence du stimulus oxygène ventilatoire chez l'homme. J. Physiol., Paris, 1960, 52:177–178.

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  • 33.

    Naeraa, N.Blood-gas analyses in unconscious neurosurgical patients on admission to hospital.Acta anaesth. scand., 1963, 7:191199.Naeraa, N. Blood-gas analyses in unconscious neurosurgical patients on admission to hospital. Acta anaesth. scand., 1963, 7:191–199.

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  • 34.

    Naeye, R. L.Alveolar hypoventilation and cor pulmonale secondary to damage to the respiratory center.Am. J. Cardiol., 1961, 8:416419.Naeye, R. L. Alveolar hypoventilation and cor pulmonale secondary to damage to the respiratory center. Am. J. Cardiol., 1961, 8:416–419.

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  • 35.

    Plum, F. & Alvord, E. C., Jr.Apneustic breathing in man.Archs Neurol., Chicago, 1964, 10:101112.Plum, F., and Alvord, E. C., Jr. Apneustic breathing in man. Archs Neurol., Chicago, 1964, 10:101–112.

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  • 36.

    Plum, F. & Posner, J. B.The diagnosis of stupor and coma. Philadelphia: F. A. Davis Company, 1966, Plum, F., and Posner, J. B. The diagnosis of stupor and coma. Philadelphia: F. A. Davis Company, 1966, 197 pp.

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  • 37.

    Plum, F. & Swanson, A. G.Abnormalities in central regulation of respiration in acute and convalescent poliomyelitis.Archs Neurol. Psychiat., Chicago, 1958, 80:267285.Plum, F., and Swanson, A. G. Abnormalities in central regulation of respiration in acute and convalescent poliomyelitis. Archs Neurol. Psychiat., Chicago, 1958, 80:267–285.

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  • 38.

    Redgate, E. S.Hypothalamus and respiratory minute volume.Am. J. Physiol., 1960, 198:13041306.Redgate, E. S. Hypothalamus and respiratory minute volume. Am. J. Physiol., 1960, 198:1304–1306.

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  • 39.

    Redgate, E. S. & Gellhorn, E.Respiratory activity and the hypothalamus. Am. J. Physiol., 1958, 193:189194.Redgate, E. S., and Gellhorn, E. Respiratory activity and the hypothalamus. Am. J. Physiol., 1958, 193:189–194.

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  • 40.

    Robin, E. D., , Whaley, R. D., , Crump, C. H. & Travis, D. M.Alveolar gas tensions, pulmonary ventilation and blood pH during physiologic sleep in normal subjects.J. clin. Invest., 1958, 37:981989.Robin, E. D., Whaley, R. D., Crump, C. H., and Travis, D. M. Alveolar gas tensions, pulmonary ventilation and blood pH during physiologic sleep in normal subjects. J. clin. Invest., 1958, 37:981–989.

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  • 41.

    Rodman, T. & Close, H. P.The primary hypoventilation syndrome. Am. J. Med., 1959, 26:808817.Rodman, T., and Close, H. P. The primary hypoventilation syndrome. Am. J. Med., 1959, 26:808–817.

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  • 42.

    Rodman, T., , Resnick, M. E., , Berkowitz, R. D., , Fennelly, J. F. & Olivia, J.Alveolar hypoventilation due to involvement of the respiratory center by obscure disease of the central nervous system.Am. J. Med., 1962, 32:208217.Rodman, T., Resnick, M. E., Berkowitz, R. D., Fennelly, J. F., and Olivia, J. Alveolar hypoventilation due to involvement of the respiratory center by obscure disease of the central nervous system. Am. J. Med., 1962, 32:208–217.

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  • 43.

    Rosenberg, R. N., , Kahn, M., , Pine, J. & Stein, M.Primary (neurogenic) alveolar hypoventilation. A case report and review of the literature.Archs Neurol., Chicago, 1966, 15:9499.Rosenberg, R. N., Kahn, M., Pine, J., and Stein, M. Primary (neurogenic) alveolar hypoventilation. A case report and review of the literature. Archs Neurol., Chicago, 1966, 15:94–99.

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  • 44.

    Ryder, H. W., , Espey, F. F., , Kristoff, F. V. & Evans, J. P.The measurement of instantaneous changes in cerebral blood flow in human beings by its effect on the cerebrospinal fluid pressure.J. Lab. clin. Med., 1950, 36:982. Ryder, H. W., Espey, F. F., Kristoff, F. V., and Evans, J. P. The measurement of instantaneous changes in cerebral blood flow in human beings by its effect on the cerebrospinal fluid pressure. J. Lab. clin. Med., 1950, 36:982.

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  • 45.

    Saito, K., , Honda, Y. & Hasumura, N. Ventilatory response to hypoxia at normal arterial pH and PCO2 in dogs.Jap. J. Physiol., 1960, 10:673681.Saito, K., Honda, Y., and Hasumura, N. Ventilatory response to hypoxia at normal arterial pH and PCO2 in dogs. Jap. J. Physiol., 1960, 10:673–681.

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  • 46.

    Schmidt, C. F.The cerebral circulation in health and disease. Springfield, Ill.: Charles C Thomas, 1950, (See pp. 6162.) Schmidt, C. F. The cerebral circulation in health and disease. Springfield, Ill.: Charles C Thomas, 1950, 78 pp. (See pp. 61–62.)

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  • 47.

    Schnedorf, J. G., , Munslow, R. A., , Crawford, A. S. & McClure, R. D.Anoxia and oxygen therapy in head injury.Surgery Gynec. Obstet., 1940, 70:628631.Schnedorf, J. G., Munslow, R. A., Crawford, A. S., and McClure, R. D. Anoxia and oxygen therapy in head injury. Surgery Gynec. Obstet., 1940, 70:628–631.

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  • 48.

    Semple, S. J. G.Respiration and the cerebrospinal fluid.Scient. basis med. (annual reviews), 1967, (See pp. 109127.) Semple, S. J. G. Respiration and the cerebrospinal fluid. Scient. basis med. (annual reviews), 1967, (See pp. 109–127.)

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  • 49.

    Shapiro, W., , Wasserman, A. J. & Patterson, J. L., Jr.Human cerebrovascular response to combined hypoxia and hypercapnia.Circulation Res., 1966, 19:903910.Shapiro, W., Wasserman, A. J., and Patterson, J. L., Jr. Human cerebrovascular response to combined hypoxia and hypercapnia. Circulation Res., 1966, 19:903–910.

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  • 50.

    Siris, J. H., , Henry, E. I. & Cukier, D. S.Occult hypoxemia complicating acute and subacute intracranial lesions.N. Y. St. J. Med., 1962, 62:14401443.Siris, J. H., Henry, E. I., and Cukier, D. S. Occult hypoxemia complicating acute and subacute intracranial lesions. N. Y. St. J. Med., 1962, 62:1440–1443.

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  • 51.

    Skinhøj, E.Regulation of cerebral blood flow as a single function of the interstitial pH in the brain: a hypothesis.Acta neurol. scand., 1966, 42:604607.Skinhøj, E. Regulation of cerebral blood flow as a single function of the interstitial pH in the brain: a hypothesis. Acta neurol. scand., 1966, 42:604–607.

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  • 52.

    Sokoloff, F.The effects of carbon dioxide on the cerebral circulation.Anesthesiology, 1960, 21:664673.Sokoloff, F. The effects of carbon dioxide on the cerebral circulation. Anesthesiology, 1960, 21:664–673.

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  • 53.

    Steinbereithner, K.Hypoxia and brain edema. Some anesthesiological correlations. In: Brain edema. Klatzo, I., and & Seitelberger, F., Eds., New York: Springer-Verlag, 1967, (See pp. 6778.) Steinbereithner, K. Hypoxia and brain edema. Some anesthesiological correlations. In: Brain edema. Klatzo, I., and Seitelberger, F., Eds., New York: Springer-Verlag, 1967, 704 pp. (See pp. 67–78.)

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  • 54.

    Tenney, S. M. & Brooks, J. G.III.Carotid bodies, stimulus interaction, and ventilatory control in unanesthetized goats.Resp. Physiol., 1966, 1:211224.Tenney, S. M., and Brooks, J. G., III. Carotid bodies, stimulus interaction, and ventilatory control in unanesthetized goats. Resp. Physiol., 1966, 1:211–224.

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  • 55.

    Troupp, H., , Kaste, M., , Kuurne, T. & Huttunenm, M.Experimental cerebral venous oxygen tension during raised intracranial pressure.J. Neurosurg., 1966, 25:638642.Troupp, H., Kaste, M., Kuurne, T., and Huttunenm, M. Experimental cerebral venous oxygen tension during raised intracranial pressure. J. Neurosurg., 1966, 25:638–642.

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  • 56.

    Watt, J. G., , Dumke, P. R. & Comroe, J. H., Jr.Effects of inhalation of 100 percent and 14 percent oxygen upon respiration of unanesthetized dogs before and after chemoreceptor denervation.Am. J. Physiol., 1943, 138:610617.Watt, J. G., Dumke, P. R., and Comroe, J. H., Jr. Effects of inhalation of 100 percent and 14 percent oxygen upon respiration of unanesthetized dogs before and after chemoreceptor denervation. Am. J. Physiol., 1943, 138:610–617.

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  • 57.

    Wilson, R. H., , Hoseth, W. & Dempsey, M. E.Respiratory acidosis. I. Effects of decreasing respiratory minute volume in patients with severe pulmonary emphysema, with specific reference to oxygen, morphine and barbiturates.Am. J. Med., 1954, 17:464470.Wilson, R. H., Hoseth, W., and Dempsey, M. E. Respiratory acidosis. I. Effects of decreasing respiratory minute volume in patients with severe pulmonary emphysema, with specific reference to oxygen, morphine and barbiturates. Am. J. Med., 1954, 17:464–470.

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  • 58.

    Wolff, H. G. & Forbes, H. S.The cerebral circulation; observations of the pial circulation during changes in intracranial pressure.Archs Neurol. Psychiat., Chicago, 1928, 20:10351047.Wolff, H. G., and Forbes, H. S. The cerebral circulation; observations of the pial circulation during changes in intracranial pressure. Archs Neurol. Psychiat., Chicago, 1928, 20:1035–1047.

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  • 59.

    Wolff, H. G. & Lennox, W. G.Cerebral circulation. XII. The effect on pial vessels of variations in the oxygen and carbon dioxide content of the blood.Archs Neurol. Psychiat., Chicago, 1930, 23:10971120.Wolff, H. G., and Lennox, W. G. Cerebral circulation. XII. The effect on pial vessels of variations in the oxygen and carbon dioxide content of the blood. Archs Neurol. Psychiat., Chicago, 1930, 23:1097–1120.

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  • Which respiratory patterns indicates increasing intracranial pressure in the brain stem?

    Cushing's triad, consisting of bradycardia, irregular respirations, and widened pulse pressures, is the body's response to increased intracranial pressure (ICP). It usually indicates a severe lack of oxygen in the brain tissue.

    What indicates increasing ICP?

    These are the most common symptoms of an ICP: Headache. Blurred vision. Feeling less alert than usual.

    How does increased ICP affect breathing?

    In animals, experimentally induced head injury or high intracranial pressure (ICP) causes a variety of circulatory and respiratory effects, such as systemic and pulmonary hemodynamic changes (2), arterial hypoxemia (3), increased CO diffusing capacity (4) and lung tissue changes (5).

    Which of the following signs and symptoms of increased ICP would appear first?

    The earliest symptom of elevated ICP is a change in mental status. Bradycardia, widened pulse pressure, and bradypnea occur later. The client may void large amounts of very dilute urine if there's damage to the posterior pituitary.