A nurse is assessing for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect?

Apical pulse rate is different than the radial pulse rate

Drop in systolic BP by 20 mm Hg when changing positions

Increase in heart rate by 20% when moving from sitting to standing

Decrease in systolic pressure by more than 10 mm Hg during inspiration

Answer and Explanation

The Correct Answer is D

A. A difference between the apical pulse rate and the radial pulse rate is more indicative of a pulse deficit, which is not specific to constrictive pericarditis.
B. A drop in systolic blood pressure by 20 mm Hg when changing positions describes orthostatic hypotension, not paradoxical blood pressure.
C. An increase in heart rate when moving from sitting to standing reflects orthostatic changes, not paradoxical blood pressure.
D. Paradoxical blood pressure refers to a decrease in systolic blood pressure of more than 10 mm Hg during inspiration, which can occur in constrictive pericarditis due to impaired filling of the heart during diastole.

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Correct Answer is B

Explanation

A. The client cannot travel by air due to security screening is incorrect; clients with ICDs can travel by air but should inform security personnel about the ICD.

B. The client should hold his cell phone on the side opposite the ICD to avoid interference with the ICD’s functioning.

C. The client can carry his ICD in a small pocket is incorrect; the ICD is implanted and does not need to be carried.

D. The client should avoid the use of small electric devices is not entirely accurate; the client should follow specific guidelines but not avoid all small devices.

A. Do not have a microwave oven in the home. B. Request to be scanned with a handheld metal detector when in the airport. C. Count your pulse for 1 min each morning. D. Do not wear tight clothing over the insertion area. E. Resume activities that can cause jolting, such as horseback riding, after 4 weeks.

Correct Answer is ["B","C","D"]

Explanation

A. Modern pacemakers are designed to withstand interference from microwave ovens, so it is not necessary to avoid having them in the home.
B. Handheld metal detectors can interfere with pacemaker function, so it is safer to request a manual search at security checkpoints.
C. Monitoring the pulse daily helps to ensure the pacemaker is functioning properly and to detect any irregularities early.
D. Wearing tight clothing over the insertion area can cause discomfort and may interfere with the function of the pacemaker.
E. Activities that involve jolting or the risk of impact to the pacemaker should be avoided until cleared by a healthcare provider, and this period may extend beyond 4 weeks.

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A nurse is assessing for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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