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Cardiac Tamponade Nursing Care Plan & Management

Notes

Description
Cardiac tamponade is the hoard of redundancy liquescent among the pericardial illimitableness, ending in adulterated cardiac supply, contraction in pat size, and epicardial coronary artery compression delay induced myocardial ischemia. Clinical sings of cardiac tamponade depends on the dispatch of the liquescent hoard and on the liquescent size. Risk factors apprehend new cardiac trauma such as known trauma to the thorax (gunshot wounds and stabs), closed trauma to the thorax (contact of the chest on a steering trundle-wallow during a motor gait garb), cardiac surgery, and iatrogenic causes (cardiac catheterization or pacemaker electrode hole). cardiac tamponade
Signs and Symptoms
  • Restlessness
  • Agitation
  • Weakness
  • Anorexia
  • Chest discomfort
  • Shortness of inspiration
  • Feeling of impending doom
  • Poor structure perfusion
Physical Examination
  • Pulsus paradoxus > 10 mm Hg (hallmark)
  • Narrowed pulse influence (<30 mm Hg)
  • Hypotension
Neurologic
  • Anxiety
  • Confusion
  • Obtunded if decompression is advanced
Cardiovascular
  • Jugular disaspect distention
  • Reflex tachycardia
  • Muffled, aloof nature sounds
Skin
  • Cool
  • Pale
  • May be clammy
Acute Care Management
Nursing Diagnosis: Decreased cardiac output connected to reduced ventricular supply induced to extensiond intrapericardial influence.
Outcome Criteria
  • Patient nimble and oriented
  • Skin fervid and dry
  • Pulses secure and correspondent bilaterally
  • Capillary satisfy <3 sec
  • HR 60 to 100 beats/min
  • BP 90 to 120 mm Hg
  • Pulse influence 30 to 40 mm Hg
  • Urine output 30 ml/hr or 1 ml/kg/hr
Patient Monitoring
  1. Continuously adviser ECG for dysrhythmia shape, which may end of myocardial ischemia induced to epicardial coronary artery compression.
  2. Monitor the BP entire 5 to 15 minutes during the clever deportment.
  3. Monitor for pulsus paradoxus via arterial tracing or during manual BP balbutiation.
  4. Monitor urine output hourly; a percolate in urine output may mark waned renal perfusion as a end of waned pat size induced to cardiac compression.
Patient Assessment
  1. Assess cardiovascular status: adviser for jugular disaspect distention and intercourse of Kussmaul’s presage.
  2. Note skin clime, garbling, and capillary satisfy.
  3. Assess abundance of femoral pulse during tranquillize warm.
  4. Assess plane of sense for changes that may mark wane cerebral perfusion.
Diagnostic Assessment
  1. Review ECG for electrical alterans.
  2. Review echocardiogram description if helpful.
  3. Review chest radiographs.
Patient Management
  1. Provide supplemental oxygen as ordered.
  2. Initiate two large-bore intravenous lines for liquescent government to celebrate supply influence.
  3. Pharmacologic therapy may apprehend dobutamine to relit myocardial contractility and wane peripheral vascularresistance.
  4. Monitor the resigned for dysrhythmias, coronary artery laceratio.
  5. Surgical agency to test and relit bleeding predicament, to desert clots in the mediastinum, to resects or known the pericardium.

Nursing Care Plan

Nursing Diagnosis
  • Ineffective Warm Pattern
Related to
  • hyperventilation
Characterized by: tachypnea, presages kussmaul warm.
Goal
  • Patterns inspiration tail effectively.
Expected outcomes
  • Tachypnea no
  • Signs kussmaul no
  • Vital presages are among recognized ranges (RR: 16-20 X / min).
Nursing Interventions
Independent
  • Monitor strictly indispensable presages, distinctly respiratory abundance.
    • Rationale: Changes in warm specimens can feign indispensable presages.
  • Monitor the divergency warm, chest expatiation, continuity of warm, hole warm and muscle use a respirator.
    • Rationale: The bud of the chest and use helper muscles mark warm specimen disorders.
  • Give the semi-Fowler aspect if not contraindicated.
    • Rationale: Facilitates lung expatiation
  • Teach clients a occult inspiration.
    • Rationale: Delay the occult warm drill can extension oxygen intake.
Collaborative
  • Give oxygen as markd.
    • Rationale: Oxygen ample to fly the lavish of structure injury.
  • Give medication as markd.
    • Rationale: Medications that can feign the respiratory zephyr.

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