The nurse is assessing the client with a pericardial effusion secondary to breast cancer. Which assessment findings are most concerning to the nurse?

Increased heart rate, audible S1 and S2. pulsus alternans, and pain rated at a 5

Temperature 96.4°F (35.8°C), heart rate 58 bpm. pulsus parvus, and shivering

Jugular vein distention, muffled heart sounds, pulsus paradoxus, and BP 84/48

Decreased heart rate, urine output 30 mL/hr. pulse deficit, and sinus rhythm with a few premature ventricular contractions