Final answer:
The nurse should immediately notify the provider if a patient with a high risk for cardiac tamponade exhibits pulsus paradoxus and muffled heart sounds. These symptoms are classic signs of cardiac tamponade, a potentially life-threatening condition requiring prompt intervention.
Step-by-step explanation:
A patient who has received a heart transplant for dilated cardiomyopathy and is at high risk for cardiac tamponade should be closely monitored for specific signs and symptoms that could indicate the development of this life-threatening condition. One of the classic signs of cardiac tamponade is pulsus paradoxus, which is an abnormal decrease in systolic blood pressure during inspiration. Another sign is muffled heart sounds that occur due to the accumulation of fluid in the pericardial space.
When a nurse observes pulsus paradoxus and muffled heart sounds, they must immediately notify the provider, as these signs suggest the presence of cardiac tamponade, which can rapidly lead to decreased cardiac output and shock if not promptly treated. On the other hand, symptoms such as crackles and wheezes of the lungs, hepatomegaly and ascites, and dependent edema and fluid retention may be suggestive of other complications such as pulmonary edema or heart failure but are not specifically indicative of cardiac tamponade.