A client was in car accident client while not wearing a seatbelt and has sustained multiple rib fractures. During assessment, the nurse is having a hard time hearing heart sounds, and the client reports chest pain/pressure repeatedly

Question

This client may be experiencing:
A) Cardiomyopathy
B) Pericarditis
C) Pulmonary hypertension
D) Pericardial effusion

Answer 1

Ans: D
Feedback:
Pericardial effusion is the accumulation of fluid in the pericardial cavity, usually as a result of an inflammatory reaction. It may develop with neoplasms, cardiac surgery, or trauma. Pericardial effusion exerts its effects through compression of the heart chambers. The normal pericardial space contains about 15 to 50 mL of fluid. Increases in the volume of this fluid, the rapidity with which it accumulates, and the elasticity of the pericardium determine the effect that the effusion has on cardiac function. This leads to cardiac standstill or failure. Pericardial sac thickening due to inflammation can restrict the heart, rather than to allow stretching. Rupture of the sac is pathologic, resulting in heart expansion. A friction rub sound (rubbing between the inflamed pericardial surfaces) is characteristic of acute pericarditis. Acquired cardiomyopathies include those that have their origin in the inflammatory process (e.g., myocarditis), pregnancy (peripartum cardiomyopathy), and stress (takotsubo cardiomyopathy). In congenital heart defects, in most cases, pulmonary vascular resistance is only slightly elevated during early infancy, and the major contribution to pulmonary hypertension is the increased blood flow.