Medical Surgical Cardiac Tamponade #4

Question

A client has had a pneumothorax and needs a chest tube placement. After the chest tube is placed, what should the nurse immediately monitor for associated with a rare, but serious complication?

Answers

  1. Cardiogenic shock
    • Rationale:

      This answer is correct because a serious, but rare complication that can occur immediately following a chest tube placement is cardiac tamponade. The client with cardiac tamponade will exhibit symptoms of cardiogenic shock. Symptoms associated with cardiogenic shock include hypotension, tachypnea, weak but a sudden, rapid heartbeat, paleness, shortness of breath, and loss of consciousness. The nurse should monitor the client closely for these symptoms.

  2. First-degree block
    • Rationale:

      This answer is not correct because first-degree heart block is not a complication directly associated with chest tube insertion. A first degree block is a slowing of a cardiac signal. It usually does not have symptoms, cause problems, or need treatment. Nevertheless, a serious, but rare complication that can occur immediately following a chest tube placement is cardiac tamponade. The client with cardiac tamponade will exhibit symptoms of cardiogenic shock. The nurse should report these symptoms immediately.

  3. Metabolic acidosis
    • Rationale:

      This answer is not correct because metabolic acidosis is not a complication directly associated with a chest tube insertion. Nevertheless, a serious, but rare complication that can occur immediately following a chest tube placement is cardiac tamponade. The client with cardiac tamponade will exhibit symptoms of cardiogenic shock. The nurse should report these symptoms immediately.

  4. ST-elevation
    • Rationale:

      This answer is not correct because ST-elevation is not a complication associated with a chest tube insertion. ST-elevation is most associated with a myocardial infarction. A serious, but rare complication that can occur immediately following a chest tube placement is cardiac tamponade. The client with cardiac tamponade will exhibit symptoms of cardiogenic shock. The nurse should report these symptoms immediately.

Overview

A serious, but rare complication that can occur immediately following a chest tube placement is cardiac tamponade. The client with cardiac tamponade will exhibit symptoms of cardiogenic shock.

Explanation

Learning Outcomes

A serious, but rare complication that can occur immediately following a chest tube placement is cardiac tamponade. The client with cardiac tamponade will exhibit symptoms of cardiogenic shock. Symptoms associated with cardiogenic shock include hypotension, tachypnea, weak but a sudden, rapid heartbeat, paleness, shortness of breath, and loss of consciousness. The nurse should monitor the client closely for these symptoms. If these symptoms occur, the healthcare provider should be notified and an emergent pericardiocentesis (removal of the excessive fluid in the pericardium). Cardiac tamponade is a serious medical emergency in which blood or other fluids fill the pericardial space (the sac that surrounds the heart). This extra fluid places increased pressure on the heart to the extent that the ventricles cannot fill and contract.

Test Taking Tip

It is good to understand what might be a risk associated with an insertion of an object into the lung area. An electrical problem involving rhythms would be less likely than a bleed that could seep into the pericardium and cause cardiac tamponade and affect the pumping ability of the heart.

Video Rationale