Practice Quiz

ANCC Medical-Surgical Nursing Exam Prep

Category - Pulmonary

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A thoracentesis is performed on a chest-injured client and no fluid or air is found. Blood and fluid is administered intravenously (IV), but the client's vital signs do not improve. A central venous pressure line is inserted and the initial reading is 20 cm H^O. The most likely cause of these findings is which of the following?
  1. Spontaneous pneumothorax
  2. Ruptured diaphragm
  3. Hemothorax
  4. Pericardial tamponade
Explanation
Answer - D - Pericardial tamponade. Pericardial tamponade occurs when there is presence of fluid accumulation in the pericardial space that compresses on the ventricles, causing a decrease in ventricular filling and stretching during diastole with a decrease in cardiac output. This leads to right atrial and venous congestion manifested by a CVP reading above normal.
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