The nurse identifies pulsus paradoxus on a patient's arterial pressure waveform monitoring when:
1. The waveform has tall, tented waves.
2. The pulse pressure is above 20 mm Hg on exhalation.
3. There is a decrease of more than 10 mm Hg in the arterial waveform before inhalation.
4. There is a single, nonperfused beat.
3
Rationale 1: This does not indicate a change in intrathoracic pressure.
Rationale 2: This does not cause a change in intrathoracic pressure.
Rationale 3: There is a change in intrathoracic pressure that affects the filling of the ventricles, which is reflected in the arterial pressure.
Rationale 4: This does not cause a change in intrathoracic pressure.
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