Which action by the nurse will determine if the therapies ordered ...

[FButt]

Which action by the nurse will determine if the therapies ordered for a patient with chronic constrictive pericarditis are effective?
 
  a. Assess for the presence of a paradoxical pulse.
  b. Monitor for changes in the patient's sedimentation rate.
  c. Assess for the presence of jugular venous distention (JVD).
  d. Check the electrocardiogram (ECG) for ST segment changes.

Question 2

The nurse is caring for a 64-year-old patient admitted with mitral valve regurgitation. Which information obtained by the nurse when assessing the patient should be communicated to the health care provider immediately?
 
  a. The patient has bilateral crackles.
  b. The patient has bilateral, 4+ peripheral edema.
  c. The patient has a loud systolic murmur across the precordium.
  d. The patient has a palpable thrill felt over the left anterior chest.

[irishcancer18]

Answer to Question 1

ANS: C
Because the most common finding on physical examination for a patient with chronic constrictive pericarditis is jugular venous distention, a decrease in JVD indicates improvement. Paradoxical pulse, ST-segment ECG changes, and changes in sedimentation rates occur with acute pericarditis but are not expected in chronic constrictive pericarditis.

Answer to Question 2

ANS: A
Crackles that are audible throughout the lungs indicate that the patient is experiencing severe left ventricular failure with pulmonary congestion and needs immediate interventions such as diuretics. A systolic murmur and palpable thrill would be expected in a patient with mitral regurgitation. Although 4+ peripheral edema indicates a need for a change in therapy, it does not need to be addressed urgently.

[FButt]

Thanks for the timely response, appreciate it

[bdobbins]

Gracias!