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- Question 1 of 1
A nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which of the following observations would indicate that the procedure was unsuccessful?Correct
Answer & Rationale:
Option 2 is Correct
Rationale: Sinus tachycardia has the characteristics of normal sinus rhythm, including a regular PP interval and normalwidth PR and QRS intervals; however, the rate is the differentiating factor. In sinus tachycardia, the atrial and ventricular rates are greater than 100 beats/min.
Test-Taking Strategy: Use the process of elimination. Eliminate options 3 and 4 because they do not meet the rate criteria (ventricular rate is 110 beats/min). Eliminate option 1 because sinus dysrhythmia is an irregular rhythm, with changing PP and RR intervals. Review the characteristics of sinus tachycardia if you had difficulty with this question.Incorrect
Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac. This is the tissue that surrounds the heart.
How the Test is Performed
The procedure is most often done in a special procedure room, such as a cardiac catheterization laboratory. It may also be done at a patient’s hospital bedside. A health care provider will put an IV into your arm in case fluids or medicines need to be given through a vein. For example, you may be given medicines if your heartbeat slows or your blood pressure drops during the procedure.
The health care provider will clean an area just below the breastbone or below the left nipple. Numbing medicine (anesthetic) will be applied to the area.
The doctor will then insert a needle and guide it into tissue that surrounds the heart. Often, echocardiography is used to help the doctor see the needle and any fluid drainage. An electrocardiogram (ECG) and x-rays (fluoroscopy) may also be used to help with positioning.
Once the needle has reached the correct area, it is removed and replaced with a tube called a catheter. Fluid drains through this tube into containers. Most of the time, the pericardial catheter is left in place so draining may continue for several hours.
Surgical drainage may be needed if the problem is hard to correct or comes back. This is a more invasive procedure in which the pericardium is drained into the peritoneal (abdominal) cavity. This may need to be done when you are under general anesthesia.
Why the Test is Performed
This test may be done to remove and examine fluid that is pressing on the heart. It is most often done to find the cause of a chronic or recurrent pericardial effusion.