Kevin is a registered nurse who works for the emergency department. He sees a lot of patients who seek services due to pain. One of the things that Kevin's learned in nursing school and has been validated in his practice is that pain is:

A. Choose a cuff that is the right size. Using the correct cuff size is essential for accurate blood pressure readings. A cuff that is too small can falsely elevate readings, while a cuff that is too large can falsely lower them.
B. Support the extremity. The arm should be supported at heart level to prevent unnecessary muscle strain, which could affect blood pressure readings. An unsupported arm may lead to an artificially higher reading.
C. Have the patient cross their legs while taking blood pressure. Crossing the legs can increase blood pressure by reducing venous return and increasing vascular resistance, leading to inaccurate measurements. The patient should keep their feet flat on the floor.
D. Ensure proper cuff application. The cuff should be placed snugly around the upper arm with the artery marker positioned correctly over the brachial artery. Improper placement can lead to inaccurate readings.
E. Ensure that the patient is sitting or lying. Blood pressure should be measured while the patient is in a stable position—either sitting with feet flat on the floor or lying down. Standing may result in postural changes that can alter blood pressure readings.

A. Instruct the client to report for weekly re-evaluations by the nurse. A pulse deficit indicates a difference between the apical and radial pulse rates, which may suggest cardiac dysfunction such as atrial fibrillation. This requires immediate evaluation, not just weekly monitoring.
B. Teach the client how to check pulses at home. While patient education is important, a pulse deficit is a clinical concern that should be addressed by a healthcare provider before self-monitoring is advised.
C. Report this finding to the physician. A pulse deficit may indicate arrhythmias or decreased cardiac output, requiring further evaluation and possible medical intervention. The physician should be informed promptly.
D. Document this finding. While documentation is necessary, the priority action is to report the pulse deficit to the physician so appropriate diagnostic tests and interventions can be initiated.