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. Instructing the client on the use of crutches is important but not as immediate as assessing for complications.

B. Performing neurovascular checks of the extremities is the most important action to identify complications such as compartment syndrome or impaired circulation.

C. Medicating the client for pain is important but secondary to monitoring for immediate postoperative complications.

D. Directing the client to perform exercises of the ankle and toes helps prevent complications but is not as critical as performing neurovascular assessments.

A. Yellow sclera B. Increasing AST level C. Weight loss D. Mantoux test result E. Increasing ALT level

Correct Answer is A

Explanation

A. Yellow sclera
Yellow sclera indicates jaundice, which could be a sign of liver dysfunction. Both isoniazid and rifampin can cause hepatotoxicity, and monitoring for jaundice is crucial to ensure the safety of the client.

B. Increasing AST level
AST level is slightly elevated but remains in the upper range of normal. Continued monitoring is necessary but may not require immediate reporting unless liver function significantly deteriorates.

C. Weight loss
Weight loss is consistent with the client’s condition and does not necessarily require immediate reporting unless it is severe or unmanageable.

D. Mantoux test result
The Mantoux test result is negative, which may be expected in the early phase of tuberculosis treatment. It should be monitored over time.

E. Increasing ALT level
ALT is slightly elevated but still within normal limits, though it's essential to continue monitoring for trends.

F. Reddish-orange urine color
Reddish-orange urine is a known side effect of rifampin and does not typically require immediate reporting

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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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