There are a few scenarios where a nurse might come into contact with a patient experiencing a cardiac tamponade. First, the nurse might be working in the ER and a patient with a tamponade arrives. On the other hand, the nurse could be working on an ICU and the patient develops a tamponade while she is caring for the patient.
In either case, nursing care is going to be similarly centered around quickly and accurately assessing the patient. As a nurse caring for a patient, our highest priority is always making sure the patient has adequate airway, breathing, and circulation (the ABC's). A change in any of these requires immediate intervention. If the patient becomes hypoxic due to poor cardiac output, we may need to initiate oxygenation, intubation, or ventilation. Our assessments of the patient need to include cardiac function (looking at BP, HR, JVD, etc), skin signs (give us information on tissue perfusion), and level of conciousness (which may be the first thing to change when a patient's status begins to decline). If a patient is currently on telemetry it is the nurses role to check his ECG changes and status.
If the patient does not have adequate IV access, the nurse should start two large bore IV lines. These will be used if the patient requires fluid resuscitation, blood products, or IV drugs. Having quick access to emergency resuscitation is also important in case the patient declines enough to need resuscitation.
Often overlooked, however, is some of the most important care that a nurse can provide, emotion support. If the patient is awake, or if the patient's family is present, the nurse should act in a controlled calm manner throughout any emergent situation and should attempt to calmly explain any procedure. A patient awake through any of these experiences is going to have a very high level of anxiety. We, as nurses, need to make sure we are caring for our patients holistically, not just treating their disease.
For more information of nursing care of patient's with cardiac tamponade please visit these two websites:
I used these resources because they are excellent at presenting a background of the disease, as well as the role of the nurse in caring for patient's with cardiac tamponade. The first site breaks down the assessments and signs and symptoms nicely. The second does a great job of giving slightly more advanced nursing interventions and details that the first did not.
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