A nurse is planning care for a client who has suspected cardiac tamponade. Which of the following diagnostic tests should the nurse anticipate the provider to order first?

Computed tomography (CT) scan

Chest x-ray

Echocardiogram

Electrocardiogram (ECG)

Answer and Explanation

The Correct Answer is C

A) Computed tomography (CT) scan: A CT scan may provide detailed images of the heart and surrounding structures, but it is not typically the initial diagnostic test used to assess for cardiac tamponade. CT scans are often used in conjunction with other diagnostic tests but are not the first-line investigation for suspected tamponade.

B) Chest x-ray: While a chest x-ray may show signs of cardiac tamponade, such as an enlarged cardiac silhouette or evidence of fluid accumulation around the heart, it is not as sensitive or specific as other diagnostic tests, particularly in the acute setting. Chest x-rays may be obtained as part of the diagnostic workup, but they are not the first-line test for suspected tamponade.

C) Echocardiogram: An echocardiogram is the most appropriate initial diagnostic test for suspected cardiac tamponade. It provides real-time imaging of the heart and can detect pericardial effusion, collapse of the right atrium and ventricle during diastole (diastolic collapse), and signs of hemodynamic compromise. Echocardiography allows for rapid assessment at the bedside and can guide immediate management decisions.

D) Electrocardiogram (ECG): While an electrocardiogram may show nonspecific changes in cardiac tamponade, such as low-voltage QRS complexes or electrical alternans, it is not as sensitive or specific as an echocardiogram for diagnosing tamponade. ECG findings may support the diagnosis but are not typically the first-line test for suspected tamponade.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "A deregulated cytokine storm causes an inflammatory response": Systemic inflammatory response syndrome (SIRS) is characterized by a dysregulated inflammatory response triggered by various insults such as infection, trauma, burns, or ischemia. In SIRS, the immune system responds excessively, leading to the release of pro-inflammatory cytokines (cytokine storm), including tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6). This cytokine cascade results in widespread inflammation and systemic manifestations, such as fever, tachycardia, tachypnea, and leukocytosis.

B. "The major organ prone to injury during SIRS is the heart": While SIRS can lead to multi-organ dysfunction, including cardiac dysfunction, it does not primarily target the heart. SIRS affects multiple organs, including the lungs, kidneys, liver, and gastrointestinal tract. Cardiac dysfunction in SIRS may result from the inflammatory response, hypoperfusion, or direct myocardial injury.

C. "Spleen dysfunction causes blood clotting issues": SIRS can lead to coagulation abnormalities, but spleen dysfunction is not the primary cause. Coagulation abnormalities in SIRS are often attributed to endothelial dysfunction, activation of the coagulation cascade, and consumption of clotting factors, rather than spleen dysfunction.

D. "Activation of the inflammatory cascade causes increased perfusion": Activation of the inflammatory cascade in SIRS does not typically lead to increased perfusion. Instead, SIRS can lead to alterations in perfusion, including tissue hypoperfusion and microvascular dysfunction. In severe cases, SIRS can progress to septic shock, characterized by profound hypotension and inadequate tissue perfusion.

A. "I should ask my son to drive me to the grocery store." B. "l will probably become easily constipated." C. "l am aware that I may develop frequent hiccups." D. "I will need to avoid strenuous activity to prevent my heart from stopping."

Correct Answer is D

Explanation

A. "I should ask my son to drive me to the grocery store." This statement does not directly address the risk for sudden cardiac death associated with arrhythmogenic cardiomyopathy. While it may be a valid safety precaution to have someone else drive, it does not specifically address the client's understanding of the condition and its implications for sudden cardiac death.

B. "I will probably become easily constipated." Constipation is not a typical manifestation or complication of arrhythmogenic cardiomyopathy. This statement does not demonstrate an understanding of the condition and its associated risk of sudden cardiac death.

C. "I am aware that I may develop frequent hiccups." Frequent hiccups are not a characteristic symptom or complication of arrhythmogenic cardiomyopathy. This statement does not indicate an understanding of the condition and its risk for sudden cardiac death.

D. "I will need to avoid strenuous activity to prevent my heart from stopping." This statement reflects an understanding of the condition and its associated risk of sudden cardiac death. Strenuous activity can exacerbate arrhythmias in individuals with arrhythmogenic cardiomyopathy, potentially leading to life-threatening arrhythmias such as ventricular fibrillation. Avoiding strenuous activity is a recommended precaution to reduce the risk of sudden cardiac death in individuals with this condition.

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A nurse is planning care for a client who has suspected cardiac tamponade. Which of the following diagnostic tests should the nurse anticipate the provider to order first?

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