When examining a patient for pulsus paradoxus, the nurse would do which of the following? Select all that apply
a. Place the patient in a supine position. Instruct the patient to breathe normally.
b. Apply the blood pressure cuff.
c. Inflate the cuff to 40 mm Hg above the patient's last systolic blood pressure reading.
d. Slowly deflate the cuff until the first systolic sound is heard.
e. Observe the patient's respirations because the systolic sound may disappear during normal inspiration.
f. Quickly deflate the cuff again and note the point at which the dyastolic sound is heard.
A, B, D, E
When examining a patient for pulsus paradoxus, the nurse would place the patient in a supine position. Instruct the patient to breathe normally, apply the blood pressure cuff, and inflate the cuff to 20 mm Hg (not 40 mm Hg) above the patient's last systolic blood pressure reading. The nurse would then slowly deflate the cuff until the first systolic sound is heard, observe the patient's respirations because the systolic sound may disappear during normal inspiration, and finally slowly deflate the cuff again and note the point at which all of the systolic sounds are heard regardless of respirations. The cuff is never deflated quickly.
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