Cardiac Tamponade Flashcards
the following flashcards are going to be about cardiac tamponade
what is the patho behind cardiac tamponade?
compression of the heart caused by fluid collecting in the pericardial sac
( weaker pump = less cardiac output )
The pericardial sac around the heart fills with fluid or blood, causing an increase in INTRAPERICARDIAL PRESSURE, that compresses the heart so it can NO LONGER FILL WITH BLOOD.
what protects the heart?
the pericardium
simple nursing brings up a good point on the patho and what leads up to the signs and symptoms for a patient with cardiac tamponade
so think of it like this
- we understand that the pericardium is a protective sac/layer around the heart that is mildly filled with fluid to help lubricate and avoid friction of the heart with other muscles during contractility, or in smaller terms, when the heart is beating. However in cardiac tamponade, the fluid will slowly fill up more and more, basically surrounding the heart with fluid and basically drowning it fully. If its drowned fully, we lose that cardiac output to the rest of the body
remember, the heart helps pump out rich oxygenated blood to the rest of the body, this is known as cardiac output
however, when we are having this issue with cardiac tamponade, we have LOW cardiac output and eventually we lose oxygen and ability to live all together if not treated well.
What are signs and symptoms often associated with low cardiac output?
whats the gold, typically the first sign and symptom of low cardiac output?
Restlessness and confusion!!! (change in LOC)
- dizzy
- fatigue
- shortness of breath
- tachycardia!! (first sign-compenstate)
when having cardiac tamponade, what is the “term” that we use to talk about the 3 major symptoms associated with this condition?
Becks triad
what are the becks triad, 3 symptoms, with cardiac tamponade?
B - Big JVD
E - extremely low blood pressure (hypotension)
C - cant hear, muffled heart sounds
What is another term that we use to describe low blood pressure in cardiac tamponade?
- describe what it means to
Pulses paradoxus
- exaggerated drop in blood pressure due to the fluid “drowning” and pushing the blood pressure down
how can we visually see a pulses paradoxus in a patient?
systolic drop by 10mmHG upon inspiration
( meaning the top and bottom numbers are also getting very close together ) 100/90 for example
What is the ECG going to look like when we have a patient with cardiac tamponade?
can you explain to me why that is?
short and uneven height
remember the heart beats normally, but if the heart is getting squished, its gonna do its best to fight back against that resistance and it’ll end up showing like this tug of war situation
- short and uneven height ( up down up down )
simple nursing using a long anagram to help us remember the major sign and symptoms to help remember all of the information we just talked about
what is the anagram?
DROWNED
what does DROWNED stand for?
D - distended neck veins
R - respiratory tract and lung clear
O - oxygen saturation low
W - weak rapid pulses ( thread )
N - no pulse
E - ECG-QRS complications ( short and even )
D - decreased cardiac output
what are the causes of cardiac tamponde?
penetrating trauma
blunt force trauma
cardiac surgery
heart attack
diseases
- cancer
- connective tissue disorders
- autoimmune ( lupus )
- renal failure
- hypothyroidism
what are the diagnostic tests that we do for a patient with cardiac tamponade ?
Chest x-ray
Echocardiogram
ECG
hemodyanmic monitoring
what is the main treatment for a patient with cardiac tamponade?
Pericardiocentesis
what are the 3 major nursing conditions for a pericardiocentesis?
- keep on cardiac monitor
- cardiac attached to a drainage system
- assess drainage ( types, odor, color, and duration )
sometimes what medications can we also give to a patient in cardiac tamponde if needed?
Digoxin - which is an inotropic drug that helps increase contractility to help with better cardiac output
a client with cardiac tamponade is placed on hemodynamic monitoring. what would be the patho or result that we would find for this patient?
increase central venous pressure and decreased cardiac output
- increase CVP because the heart is trying to pump very hard, but nothing is gonna be coming out, meaning having low cardiac output
question from the nclex book
- the nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. the nurse determines that the procedure was effective when noting the following, when comparing preprocedure and postprocedure assessment findings.
- clear breath sounds
- increased blood pressure
- normal jugular veins
- decreased central venous pressure
- signs of increased cardiac output
( blood pressure and pulse rate and rhythm normal for the client, strong peripheral pulses, no chest pain, dyspnea, or syncope )
