(^44) Medical-Surgical Nursing Demystified
- ST-segment elevation.
- Echocardiogram shows echo-free space between pericardium and the ven-
tricular wall due to effusion; also shows fluid in the pericardial space. - CXR may show fluid in spaces.
TREATMENT
Treatment is directed at resolving the underlying etiology.
Pericardiocentesis is done to remove fluid from the pericardial sac to relieve
pressure on the heart or for diagnostic testing. A long cardiac needle is inserted
near the xiphoid process and fluid is aspirated during careful cardiac monitoring.
Pericardial biopsy- Administer corticosteroids to decrease inflammation of pericardium.
- Methylprednisolone.
- Administer nonsteroidal anti-inflammatory (NSAID) drugs to decrease in-
flammation of the pericardium and provide for pain relief.- Aspirin, indomethacin.
NURSING DIAGNOSES
- Acute pain
- Decreased cardiac output
- Risk for activity intolerance
NURSING INTERVENTION
- Place the patient in full Fowler’s position to ease breathing.
- Explain to the patient:
- He/she will recover.
- Slowly resume daily activities.
- Plan for rest periods during the day due to fatigue.
- Perform coughing and deep breathing exercises—patient may have been
avoiding deep breathing due to discomfort.