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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Correct Answer is D

Explanation

Cushing's Triad is a set of three classic signs associated with increased intracranial pressure (ICP). These signs include hypertension, bradycardia, and irregular respirations. The presence of Cushing's Triad indicates severe brain injury or increased ICP, often leading to brainstem compression.

A. Tachycardia (Option A): Increased intracranial pressure can initially lead to tachycardia as the body attempts to compensate for the changes. However, as ICP continues to rise and brainstem compression occurs, the sympathetic response diminishes, resulting in bradycardia rather than tachycardia. Therefore, Cushing's Triad is not associated with preventing tachycardia.

B. Agonal breathing (Option B): Agonal breathing, characterized by gasping, labored breathing, or irregular breathing patterns, may occur as a result of brainstem dysfunction or damage. Cushing's Triad, indicative of increased ICP and impending brainstem herniation, does not prevent agonal breathing. In fact, irregular respirations are part of Cushing's Triad.

C. Chest pain (Option C): Chest pain may occur due to various cardiac or respiratory conditions and is not directly related to Cushing's Triad or increased intracranial pressure. Therefore, Cushing's Triad does not prevent chest pain.

D. Brainstem ischemia (Option D): Increased intracranial pressure can lead to brainstem compression, compromising blood flow to the brainstem and resulting in brainstem ischemia. Cushing's Triad, characterized by hypertension, bradycardia, and irregular respirations, is a nervous system response indicative of severe brain injury or increased ICP, which can lead to brainstem ischemia if left untreated. Therefore, Cushing's Triad is associated with brainstem ischemia rather than preventing it.

A. "l should not drive while taking this new medication." B. "This new medication may decrease my sex drive." C. "This medication can make me have mood swings." D. "l may have frequent hiccups while taking this medication." E. "l may have urinary incontinence while taking this medication."

Correct Answer is ["A"]

Explanation

A. "I should not drive while taking this new medication."

Carvedilol is a beta blocker commonly prescribed for conditions like cardiomyopathy. One of the potential side effects of beta blockers, including carvedilol, is dizziness or drowsiness. These effects can occur, particularly when starting the medication or when the dosage is increased. Therefore, it's crucial for patients to understand that they may experience these symptoms and should avoid activities that require alertness, such as driving or operating heavy machinery, until they are aware of how the medication affects them. This precaution helps ensure their safety and the safety of others on the road.

B. "This new medication may decrease my sex drive."

Sexual dysfunction, including decreased libido or erectile dysfunction, is a recognized side effect of beta blockers like carvedilol. These medications can affect the autonomic nervous system and interfere with normal sexual function in some individuals. It's essential for patients to be aware of this potential side effect and to discuss any concerns with their healthcare provider. Open communication about sexual health can help address any issues that arise and explore alternative treatment options if necessary.

C. "This medication can make me have mood swings."

While mood changes are possible side effects of some medications, including certain classes of antidepressants or corticosteroids, they are not typically associated with beta blockers like carvedilol. Beta blockers primarily affect the cardiovascular system by blocking the effects of adrenaline, leading to decreased heart rate and blood pressure. While some patients may experience fatigue or depression as a side effect of beta blockers, mood swings are not a common manifestation. Therefore, this statement does not accurately reflect the potential side effects of carvedilol.

D. "I may have frequent hiccups while taking this medication."

While gastrointestinal side effects such as nausea, vomiting, or diarrhea are possible with carvedilol, frequent hiccups are not a commonly reported side effect of this medication. Hiccups, though often benign, can occasionally be bothersome or indicative of an underlying issue. However, they are not typically associated with beta blockers like carvedilol. Therefore, this statement does not accurately reflect the potential side effects of the medication.

E. "I may have urinary incontinence while taking this medication."

Urinary incontinence is a potential side effect of beta blockers like carvedilol. These medications can affect bladder function by relaxing the smooth muscle of the bladder and urethra, leading to urinary retention or incontinence in some individuals. Patients should be aware of this possibility and discuss any urinary symptoms with their healthcare provider. Depending on the severity of the symptoms, adjustments to the medication regimen or additional treatments may be necessary to manage urinary incontinence effectively.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is ["A"]

Explanation

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