Cardiac Tamponade Practice Questions with Answers and NCLEX® Review

Cardiac Tamponade Introduction

Cardiac tamponade (also called pericardial tamponade or cardiac compression) is a condition where blood collects inside the pericardial sac. This condition occurs when there is an imbalance between the amount of blood being pumped by the heart and the ability of that blood to leave the heart muscle.

This results in blood collecting inside the pericardial sac, which is a membrane surrounding the heart. Treatment for cardiac tamponade includes surgical intervention to drain any blood from around the heart.

Cardiac Tamponade Pathophysiology

Cardiac tamponade occurs when excess fluid (including blood) builds up in the pericardium. This occurs when blood or fluid blocks the heart’s ability to expand and contract normally with each beat. Cardiac tamponade can result from trauma or manifest as a complication after surgery or childbirth in the case of hemorrhage.

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Cardiac tamponade is a serious medical emergency. If not treated quickly and correctly, it can lead to death.

Memory Trick

• Cardiac tamponade
• Compression on the heart
• Critical client!

Signs and Symptoms of Cardiac Tamponade 

Typical signs and symptoms of cardiac tamponade include: 

• Severe chest pain
• Fatigue
• Shortness of breath and rapid breathing
• Nausea
• Vomiting
• Irregular heartbeat
• Rapid pulse
• Low blood pressure
• Lightheadedness or dizziness

Nurses need to be aware of these classic signs and symptoms of cardiac tamponade:

• Becks Triad (BEC)
  • Big Jugular Veins Distention (JVD)
  • Extreme Low BP (Hypotension)
  • Can’t hear heart sounds (muffled)
• Pulsus Paradoxus
  •  Systolic drop of 10 mmHg
  •  (120/80 to 110/80)
• ECG
  •  QRS complexes
  •  (short and uneven height)

Cardiac Tamponade Causes

Cardiac tamponade can be acute or chronic, and is typically caused by cardiac trauma. The most common causes of cardiac tamponade are: 

• Coronary artery disease (CAD)
• Blunt trauma
• Ruptured aortic aneurysm
• Idiopathic pericarditis
• Malignancy
• Recurrent subarachnoid hemorrhage

Nursing Interventions for Cardiac Tamponade

Administer oxygen via nasal cannula, volume expansion with IV fluids, and various medications as prescribed.

Monitor clients’ oxygen saturation levels, cardiac status (heart rate and rhythm), blood pressure, and pulse.

Assist with cleaning the client’s chest with a sponge bath.

Ensure that all IVs are infusing properly, and clients receive oxygen at all times.

Cardiac Tamponade Conclusion

Cardiac tamponade occurs when fluid builds up around the heart, restricting its normal ability to expand and contract with each beat. It can occur if fluid is leaking from somewhere else in the chest or abdominal cavity, like if a client had surgery on their esophagus or a hemorrhage.

Cardiac tamponade is a serious medical emergency. If not treated quickly and correctly, it can lead to death.

Sources

https://my.clevelandclinic.org/health/diseases/21906-cardiac-tamponade 

https://medlineplus.gov/ency/article/000194.htm