Progressive Care Nursing Certification (PCCN) Practice Exam

What should the nurse anticipate for a patient showing signs of cardiac tamponade following cardiac surgery?

1. Needle decompression

2. Echocardiogram

3. Administration of dopamine

4. Spiral CT

The correct answer is: Echocardiogram

In the context of a patient exhibiting signs of cardiac tamponade, especially following cardiac surgery, an echocardiogram is a critical diagnostic tool to assess the presence and extent of fluid accumulation in the pericardial space. This imaging technique offers real-time visualization of the heart and surrounding structures, allowing healthcare professionals to determine whether fluid is compressing the heart and potentially affecting its function. Recognizing the classic signs of cardiac tamponade—such as hypotension, muffled heart sounds, and distended neck veins—is vital, and the echocardiogram serves as a non-invasive and effective method to confirm the diagnosis quickly. While other choices may play a role in different contexts of patient care, they are not the immediate or standard responses to diagnosing cardiac tamponade. For instance, needle decompression is a therapeutic intervention rather than a diagnostic one, typically used in emergencies like tension pneumothorax. Dopamine administration may be utilized to support heart function in cases of shock, but it does not address the underlying issue of fluid accumulation. Spiral CT might be helpful in evaluating other conditions but is not the primary choice for identifying cardiac tamponade, as echocardiography is both safer and more accessible in acute clinical settings.