cardiac tamponade

Question 1

s/s

Answer 1

• muffled heart sounds on auscultation
• narrow pulse pressure
• jugular vein distention
• pulse paradoxus (systolic drop in bp 15 during inspiration)
• restlessness
• upright leaning forward posture

Question 2

key test results

Answer 2

*CXR (slightly widened mediastinum & cardiomegaly
*echocardiography records pericardial effusion w/signs of
right ventricular and atrial compression
*ECG used to rule out other cardiac d/o-not useful to
diagnose cardiac tamponade

Question 3

key treatments

Answer 3

• surgery: pericardiocentesis or thoracotomy
• andrenergic agent: epinephrine
• inotropic agent: dopamine

Question 4

key interventions: pericardiocenthesis

Answer 4

*keep pericardial aspiration needle attached to a 50 ml
syringe by a three-way stopcock, ECG machine, and
emergency cart w/defibrillator at bedside
*equipment turned on and working
*monitor bp & cVp during and after procedure for
hypotension (indicates cardiac chamber puncture)
*watch for complications: ventricular fibrillation, vasovagul
response, coronary artery or cardiac chamber puncture

Question 5

key interventions: thoracotomy

Answer 5

*explain procedure to pt.
*what to expect post op: chest tubes, drainage system,
o2 admin
*teach how to turn, deep-breath, and cough
*maintain chest tube drainage system and be alert for
hemorrhage and arrhythmias