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. Fluids should not be restricted; adequate hydration is necessary to help flush the contrast dye used during the procedure out of the client's system.
B. Performing neurovascular checks with vital signs is essential to monitor for complications such as bleeding, hematoma, or compromised circulation to the extremity.
C. The client should avoid range-of-motion exercises to the lower extremities immediately following the procedure to prevent disruption of the femoral artery site.
D. The client should remain on bed rest for several hours following the procedure to reduce the risk of bleeding at the catheter insertion site.

A. Flex the client's hip. B. Hyperextend the client's neck. C. Provide warming measures for the client. D. Adjust the client's head of bed.

Correct Answer is D

Explanation

A. Flex the client’s hip is incorrect. Flexing the hip can increase intra-abdominal pressure and potentially increase intracranial pressure.

B. Hyperextend the client’s neck is incorrect. Hyperextension of the neck can interfere with venous return from the brain and increase ICP.

C. Provide warming measures for the client is incorrect. Warming measures are not indicated for a low CPP; maintaining normothermia is important, but warming is not the priority action.

D. Adjust the client’s head of bed is correct. Elevating the head of the bed helps reduce ICP and improves cerebral perfusion by promoting venous outflow.

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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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