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65 Cards in this Set
- Front
- Back
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What does the Stress test help determine? |
Presence of Coronary Artery Disease (CAD). Cause of chest pain. Functional ability of heart after MI/heart surgery. Effectiveness of antiarrhythmia or antianginal. Occurrence of dysrhythmias. Specific goals for a physical fitness program. |
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What are the contraindications of a stress test?
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Severe aortic stenosis, acute myocarditis/pericarditis, severe hypertension, suspected main left CAD, HF, or unstable angina. |
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True or false cardiac imaging takes place during the resting phase and after the stress test. |
True |
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How long prior to a stress test should you fast? |
4 hours |
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True or false: you should avoid stimulants such as tobacco or caffeine prior to the stress test |
True |
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How long is the patient monitored after the stress test? |
15 minutes |
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Normal level of total cholesterol |
<200 |
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Normal level of triglycerides |
<150 |
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Healthy capillary refill time |
<3 seconds |
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When listening to heart sounds what do you listen to? |
Aortic-2nd R. intercostal space,R. sternal bordr. Pulminary-2nd L. (ICS), L. sternal border. Erb's point-3rd L. ICS, L. sternal border. Tricuspid valve area-4th L. ICS, L. sternal border Mitral valve area-5th ICS, L. mid-clavicular line. |
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HDL level |
For men: 35-70 mg/dl For women: 35-85 mg/dl |
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LDL level |
<160 mg/dl |
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Partial Thromboplastin time |
60-70s |
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What are the factors that contribute to cholesterol level? |
Age Gender Diet Exercise patterns Genetics menopause Tobacco use Stress levels |
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Wha is Brain Natriuretic Peptide (BNP)? |
A neurohormone that regulates blood pressure and fluid volume. |
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What is a healthy BNP level? |
100 pg/ml |
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What is C-reactive protein? |
A protein produced by the liver in response to a systematic inflammation. |
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True or false: inflammation is said to be correlative of artherosclerosis? |
True. |
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What are the three C-reactive protein levels? |
1 mg/L - low risk for CVD. 1-3 mg/L - moderate risk of CVD. +3 mg/L - high risk of CVD. |
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What is a holter monitor used for? |
It is used to monitor the heart for 24 hours. |
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What is Homocysteine? |
An amino acid linked to the development of artherosclerosis because it can damage the endothelial lining of arteries and promote thrombus formation. |
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What is said to increase levels of homocysteine amino acid? |
Genetics Low vitamin B6 Low vitamin B12 Low folate |
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How long should someone fast prior to receiving an accurate homocysteine blood test? |
12 hours prior |
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What are the three levels of a homocysteine measurement? |
<12 mcmol/L - optimal. 12-15 mcmol/L - Borderline. >15 mcmolL - high risk for CVD, PVD, and stroke. |
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What is an EKG? |
A graphical representation of the electrical currents of the heart. |
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What is an echocardiogram?
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A noninvasive ultrasound test that is used to measure the ejection fraction and examine the size, shape and motion of cardiac structures. |
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What is an echocardiogram particularly useful to diagnose? |
Pericardial effusions Determining chamber size The etiology of heart murmurs Evaluating the function of heart valves Evaluating ventricular wall motion |
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How is an echocardiogram performed? |
Echocardiography monitoring is performed while a wand that emits sound waves is moved over the surface with a gel applied to the skin helps transmit the sound waves. Periodically, the patient is asked to move from left to right or hold their breath. |
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How long prior to an echocardiogram is a patient asked not to eat or drink? |
6 hours |
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How long does the test take? |
30-45 minutes |
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True or false: Ultrasound loses its clarity as it passes through tissue, lung, and bone |
True |
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What is Transesophageal Echocardiogram? |
Provides clearer images since ultrasound waves need to travel through less tissue. Patient must swallow the transducer for viewing of the esophagus. |
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Prior to a Transesophageal Echocardiogram what must be assessed by the nurse? |
The patient must be assessed before TEE for a history of dysphagia or radiation therapy to the chest, which increases the likelihood of complications. |
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What must the nurse monitor during a Transesophageal Echocardiogram? |
Blood pressure, EKG, level of consciousness, respiration and oxygen saturation. During the recovery phase must set head rest at 45 degrees. |
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True or false: it's normal for a patient to have a sore throat for the next 24 hours |
True |
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True or false: it's normal for a patient to show the presence of a persistent sore throat, shortness of breathe and dysphagia. |
False |
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What is transtelephonic monitoring |
EKG for the home. Electrodes should not be placed over bony areas due to unclear readings. |
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What is a Cardiac Catheterization? |
An invasive diagnostic procedure in which radiopaque arterial and venous catheters are advanced into the right and left heart. Gold standard to diagnose CAD. |
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Prior to the implant of a cardiac catheter how long should a patient fast? |
8 to 12 hours prior |
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True or false: It is normal for a pounding sensation to occur in the chest during a cardiac catherization procedure. |
True |
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What is the purpose of coughing during the cardiac catheterization procedure? |
To clear dysrhythmias and contrasting agent from the artery. |
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What is the purpose of breathing deeply and holding your breath during a cardiac catheterization procedure? |
It helps lower the diaphragm for better viewing of the heart structures. |
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How long must a patient stay in bed after a cardiac catheterization procedure? |
2-6 hours |
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What is an angiography? |
An imaging technique that involves the injection of a radiopaque contrast agent into the arterial catheter. |
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What is a PTCA? |
A minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. |
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What is a CABG? |
A type of surgery that improves blood flow to the heart using grafts. |
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What is the definition of Coronary Artery Disease? |
Oxygen demands exceed the supply from diseased vessels, leading to myocardial ischemia. |
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Differences between beta 1 and beta 2 receptors |
Beta 1 found in the heart Beta 2 found in uterus, blood vessels, and Bronchi. |
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What are Beta adrenergic blockers |
Beta-adrenergic blockers are used in the treatment of CAD to decrease the myocardial oxygen by reducing heart rate and workload of the heart. |
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How do nitroglycerides affect the body? |
Promote vasodilation |
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How do anti-lipid drugs affect the body? (Statins/Vit B) |
Decrease homocysteine levels |
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How do ACE inhibitors affect the body? |
ACE inhibitors inhibit the conversion of angiotensin 1. |
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CAD treatment |
Control risk factors Low cholesterol diet Stop smoking Maintain ideal body weight Exercise regularly Moderate alcohol intake Monitor blood pressure Follow low sodium diet |
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What is a coronary atherectomy? |
Surgical removal plaque or atheroma in a major artery. |
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What is a coronary artery stent? |
A rod or threadlike device forsupporting tubular structures during surgical anastomosis |
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What is Angina pectoralis? |
Chestpain resulting from restriction of blood flow. |
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True or false: decreased blood flow result in myocardial ischemia |
True |
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What is the etiology of Angina pectoralis? |
Associated with obstruction of at least one major coronary artery which results in a decrease in oxygen supply. |
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What are the three type of Angina? |
Stable Angina Unstable Angina Variant Angina |
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What is stable Angina? |
Predictable angina that pain dissipates with rest and administration of NTG. |
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What is unstable Angina? |
Progressively worsening with increased frequency and severity. May not be treated with rest or NTG. |
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What is variant Angina? |
Occurs spontaneously with no correlation of to activity. Occurs at rest due to spasm is seen as reversible ST elevation. |
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What questions do you ask to assess for Angina? |
Whereis the pain? Canyou feel the pain anywhere else? Describethe pain? Canyou rate the pain on a 0 to 10 scale? Whendid the pain begin? Howlong does it last? Whatbrings on the pain? Whathelps the pain go away? Doyou have nay other symptoms with the pain? |
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Side effects of Nitroglycerine? |
Headache Hypotension Dizziness Flushing Tachycardia |
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Patient teaching of NGT: |
Mouth must be moist Keep in dark glass bottle. Should be renewed every 6 months. If pain persists after taking a sublingual tablet every 5 minutes for 3x (meaning in 15 minutes in total you'll know) call the physician. |
