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

Apical pulse rate different than the radial pulse rate

Increase in heart rate by 20% when standing

Drop in systolic BP by 20 mm Hg when moving from a lying to a sitting position

Drop in systolic BP more than 10 mm Hg on inspiration

Answer and Explanation

The Correct Answer is D

Choice A reason: An apical pulse rate different than the radial pulse rate is known as a pulse deficit, which can indicate atrial fibrillation or other cardiac arrhythmias, but it is not related to paradoxical blood pressure or constrictive pericarditis.

Choice B reason: An increase in heart rate by 20% when standing is indicative of orthostatic hypotension, not paradoxical blood pressure. This condition involves a drop in blood pressure upon standing, leading to a compensatory increase in heart rate.

Choice C reason: A drop in systolic BP by 20 mm Hg when moving from a lying to a sitting position is another indicator of orthostatic hypotension, not paradoxical blood pressure.

Choice D reason: The correct answer is d because a drop in systolic BP of more than 10 mm Hg on inspiration, known as pulsus paradoxus, is a characteristic finding in constrictive pericarditis. This occurs due to the impaired filling of the heart during inspiration, leading to a significant drop in systolic blood pressure.

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Correct Answer is D

Explanation

Choice A reason: Placing tissue soiled with respiratory secretions in a paper bag for later disposal is not an appropriate infection control measure. Used tissues should be disposed of immediately in a proper waste receptacle to prevent the spread of tuberculosis bacteria.

Choice B reason: Sputum cultures should be provided more frequently than every 6 weeks to monitor the effectiveness of the treatment and to confirm when the client is no longer infectious. Monthly cultures are typically recommended until the patient shows no signs of active infection.

Choice C reason: Consuming alcohol in moderation while taking antituberculosis medications is not advised. Alcohol can interfere with the effectiveness of the medications and may also exacerbate potential side effects, such as liver toxicity, especially with medications like isoniazid and rifampin.

Choice D reason: The correct answer is d because wearing a mask while out or around crowds of people helps prevent the spread of tuberculosis. TB is an airborne disease, and wearing a mask reduces the risk of transmitting the infection to others.

A. "Why have you changed your mind about the surgery?" B. "Bypass surgery must be very frightening for you." C. "Your provider would not have scheduled the surgery unless you needed it." D. "I will call your doctor and have him discuss your surgery with you."

Correct Answer is B

Explanation

Choice A reason: Asking "Why have you changed your mind about the surgery?" may come across as confrontational or judgmental. It does not address the client's emotions and may make the client feel defensive.

Choice B reason: The correct answer is b because acknowledging the client's feelings by saying, "Bypass surgery must be very frightening for you," shows empathy and understanding. It opens up a supportive conversation where the client can express concerns and emotions related to the surgery.

Choice C reason: Telling the client, "Your provider would not have scheduled the surgery unless you needed it," may dismiss the client's concerns and make them feel that their feelings are not important. It is important to address the client's emotional state and provide support.

Choice D reason: While it is appropriate to involve the healthcare provider in discussing the surgery, simply stating, "I will call your doctor and have him discuss your surgery with you," without first addressing the client's emotions and concerns, may seem dismissive. Providing emotional support should be the first step.

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

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