Cardiac Tamponade

Nursing Dx

Etiology:
Cardiac tamponade, also known as pericardial tamponade, is when fluid in the pericardium builds up and, resulting in the reduced ventricular filling and subsequent hemodynamic compromise. The condition is a medical emergency, the complications of which include pulmonary edema, shock, and death.Common causes include cancer, MI, kidney failure, chest trauma, and pericarditis.Other causes include connective tissue diseases, hypothyroidism, aortic rupture.

Collaborative Care:


  • Increase fluid volume
  • Hemodynamic monitoring
  • Pericardiocentesis
  • Pericardial window
  • Pericardiectomy

Excess fluid volume related to increased venous pressure.

  1. Auscultate the lung for the presence of adventitious breath sounds.
  2. Monitor client’s intake and output.
  3. Assess for edema.

Ineffective tissue perfusion related to reduction of blood flow.

  1. Assess capillary refill.
  2. Monitor oxygen saturation and arterial blood gasses.
  3. Restrict the patient’s activity, and maintain the client on a bed rest.

Decreased cardiac output related to impaired left ventricular contractility.

  1. Assess the client’s HR, BP, and pulse pressure.
  2. Monitor oxygen saturation and arterial blood gasses.
  3. Assess fluid balance and weight gain.

Drug Therapy:

  • Antibiotics
  • NSAIDS
  • Corticosteroids

Assessment:
-Chest pain
-Altered LOC
-Anxiety
-Confusion
Restlessness
-Decreased Cardiac Output
-Narrowed Pulse pressure
-Tachypnea
-Tachycardia
-Jugular Venous Distention
-Pulsus Parodoxus
-IF onset is slow the only symptom may be dyspnea

Diagnostics:
-ECG: widespread ST segment elevations
-CT
-MRI
-Chest X Ray
-Elevated CRP
-Elevated ESR
-Elevated Troponin levels may occur with myocardial damage
-Culture serous fluid from pericardiocentesis

Incidence: The incidence of cardiac tamponade is 2 cases per 10,000 population in the United States. Approximately 2% of penetrating injuries are reported to result in cardiac tamponade. More common in Men than women.

Pathophysiology

Accumulation of fluid under high pressure: compresses cardiac chambers & impairs diastolic filling of both ventricles

Decrease stroke volume

Decrease the cardiac output

Shock and sudden death

Increased venous pressures

Pulmonary congestion

Increase Jugular venous pressure

Hepatomegaly , ascites, peripheral edema