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.
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.
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