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 []

Explanation

1. Condition: Acute Compartment Syndrome

Justification: The presence of severe pain, swelling, numbness, and a weak radial pulse along with delayed capillary refill are classic signs of acute compartment syndrome. Immediate surgical intervention (fasciotomy) is necessary to relieve the pressure within the muscle compartments.

2. Actions to Take

Prepare for Fasciotomy:

Justification: This surgical procedure will relieve the internal pressure causing the symptoms.

Request Prescription for Pain Medication:

Justification: Adequate pain management is important for client comfort and can also indicate response to treatment.

3. Parameters to Monitor

Neurovascular Status:

Justification: Monitoring for further deterioration of symptoms such as worsening numbness or weak pulses is essential.

WBC Count:

Justification: Helps in the broader assessment of possible infection, though not directly related to acute compartment syndrome

A. Encourage the use of the wide grip utensils. B. Remind the client to look for food on the left side of the tray. C. Encourage the client to use his right hand when feeding himself. D. Provide a nonskid mat to alleviate plate movement.

Correct Answer is B

Explanation

A. Wide grip utensils may help with grasp but do not address visual field deficits.
B. Homonymous hemianopsia involves loss of vision in one half of the visual field; reminding the client to look to the left side of the tray helps them find food in their impaired visual field.
C. Using the right hand is not specifically beneficial for visual field deficits and may not address the issue of homonymous hemianopsia.
D. A nonskid mat helps prevent plate movement but does not address the visual field deficit caused by homonymous hemianopsia.

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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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