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. Coffee has not been shown to significantly increase the risk of gout attacks and may even have a protective effect due to its antioxidant properties.

B. Alcohol, especially beer and spirits, can trigger gout attacks by increasing the level of uric acid in the blood. Alcohol consumption should be limited or avoided to reduce the risk of gout flare-ups.

C. Milk and other low-fat dairy products are actually recommended for people with gout, as they may help lower uric acid levels.

D. Orange juice, while high in vitamin C, does contain fructose, which can increase uric acid production. However, it is not as significant a trigger as alcohol. Moderation is key.

A. The client has a paralytic ileus. B. The client is experiencing a myocardial infarction. C. The client who has bronchitis pleurisy. D. The client who is 24 hr postoperative following hip arthroplasty.

Correct Answer is A

Explanation

A. The client has a paralytic ileus is correct. Morphine can cause decreased gastrointestinal motility, which can exacerbate a paralytic ileus.

B. The client is experiencing a myocardial infarction is incorrect. Morphine is commonly used to manage pain and reduce myocardial oxygen demand during a myocardial infarction.

C. The client who has bronchitis pleurisy is incorrect. Morphine can be used for pain control in pleurisy, but it is not contraindicated.

D. The client who is 24 hr postoperative following hip arthroplasty is incorrect. Morphine is used for postoperative pain management.

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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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