A nurse is caring for a client who has developed cardiac tamponade. Which of the following symptoms should the nurse expect to observe?

Choice A rationale
Standing frequently can help promote blood flow in the legs, which can be beneficial for a patient with arterial insufficiency. This is because standing engages the muscles in the legs, which helps push blood back up towards the heart.
Choice B rationale
Walking without shoes is not typically recommended for patients with arterial insufficiency. This is because these patients often have reduced sensation in their feet and may not notice if they step on something sharp or if a wound develops.
Choice C rationale
Vigorous massage of the legs is not usually recommended for patients with arterial insufficiency. While gentle massage can help promote blood flow, vigorous massage could potentially damage the arteries further.
Choice D rationale
Allowing the legs to dangle dependently often is not typically recommended for patients with arterial insufficiency. This position can actually increase swelling and discomfort in the legs.

The correct answer is Choice D.

Choice A rationale: Allergies to shellfish may indicate iodine allergy, relevant for procedures using iodine-based contrast, like PCI. The client’s shellfish allergy must be reported to the PHCP as a precautionary measure to prevent any allergic reaction.

Choice B rationale: Warm sensations during PCI are a common side effect of the contrast dye used in the procedure. This statement does not indicate an immediate concern requiring PHCP notification as it is a standard patient experience.

Choice C rationale: Anxiety in closed spaces, known as claustrophobia, may affect the client's comfort during PCI but can be managed with sedatives. The PHCP should be aware but it’s not as urgent as taking contraindicated medications.

Choice D rationale: Metformin can lead to lactic acidosis, especially when iodine contrast dye is used during PCI. This condition is serious and may result in adverse interactions. The PHCP must be notified immediately.