CHAPTER 1 Cardiovascular System^21
- Don’t elevate leg or apply heat if occlusion affects the femoral or popliteal
arteries. - Elevation of the lower extremities makes it harder for the blood flow to get
to the tissues. - Avoid prolonged sitting, which increases the risk of compression to vessels
(impeding blood flow to lower extremities) and increases risk of clot forma-
tion in lower extremities. - Explain to the patient:
- How to check pulses in the affected area if there is an absence of a pulse.
- Call the physician if the patient experiences numbness, paralysis, or pain.
- Don’t wear tight clothes; avoid tight knee-high hose, which constricts at
the popliteal space; avoid tight waist bands; ensure wide shoe box. - Change his/her lifestyle to reduce the risk of peripheral arterial occlusive
disease. - The importance of regular examinations.
- Foot check daily for open wounds, redness.
- Regular visits to podiatrist.
- Regular consults to vascular MD.
Cardiac Tamponade
WHAT WENT WRONG?
A large amount of liquid accumulates in the sack around the heart (pericardium),
creating pressure on the heart that reduces the filling of ventricles with blood. This
results in a low volume of blood being pumped with each contraction. The accu-
mulating pressure within the pericardium may be due to fluid, pus, or blood. The
end result is decreased stroke volume and cardiac output.
The cause of tamponade may be trauma, postoperative, post-MI, uremia, or
cancer. The fluid may develop rapidly or over time, depending on cause. Tamponade
is a life-threatening condition. The seriousness is related to the amount of pressure
within the heart and the resulting decrease in ventricular filling.
PROGNOSIS
Cardiac tamponade is a medical emergency requiring immediate intervention, such
as drainage of the fluids. Stabilization occurs quickly once the fluid is removed and
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