Which of the following is considered a late sign of increased intracranial pressure?

Decreased respiratory effort is indeed a concerning sign that can indicate increased intracranial pressure (ICP), particularly in late stages. As ICP rises significantly, it can lead to herniation of brain tissue, which impacts the area responsible for regulating respiratory functions. Specifically, pressure on the brainstem, where vital respiratory centers are located, can result in diminished or irregular respiratory effort. This signifies a critical deterioration in the patient's neurological status and requires immediate medical intervention.

Increased ICP is often associated with a progression of symptoms that may start with more subtle signs, such as headache, and can escalate to marked changes in vital signs like bradycardia and hypertension. While these are also important indicators to monitor in relation to ICP, they may present earlier in the evolution of raised pressure. Decreased respiratory effort, on the other hand, tends to arise when the condition is becoming more severe and the brain's ability to protect vital functions is compromised. Thus, it is crucial for practitioners to recognize this late sign as part of the overall assessment and to respond appropriately to prevent further complications.