Cardiac Diagnostic Studies

Front 1

this blood study measures 2 cardiospecific enzymes & is used to support the diagnosis of myocardial muscles injury

Back 1

CK-MB
(creatine-kinase w/ the MB isoenzyme, which is specific to myocardial cells)

Front 2

serum levels of these enzymes will increase 4-6 hrs after a MI

Back 2

CK-MB

Front 3

how often should RN tell Pt that their CK-MB will be checked following a suspected MI

Back 3

every 6-8 hrs x3 (in conjunction with seriel ECGs)

Front 4

this blood study measures the serum levels of contractile proteins that are released following an MI

Back 4

cardiac-specific troponins

Front 5

this blood study measures the low-molecular-wt protein that is 99-100% sensitive for myocardial injury

Back 5

myoglobin

Front 6

serum concentrations of myoglobin will rise how fast after an MI

Back 6

30-60 min

Front 7

serum myoglobin levels are most diagnostic if measured when?

Back 7

w/in 12 hrs of onset of chest pain

Front 8

this blood study measures the marker for inflammation that can predict risk of cardiac disease & cardiac events - even in Pts w/ nrml lipid lvls.

Back 8

CRP (C-reactive protein)

Front 9

this test may be a more predictive risk factor indicator of cardiac disease for women than LDLs

Back 9

CRP (C-reactive protein)

Front 10

this value indicates normal levels of CRP

Back 10

<1 mg/L

Front 11

this value of CRP indicates a high risk for cardiac disease

Back 11

>3 mg/L

Front 12

this blood study measures the amino acid produced during protein catabolism that has been identified as a risk factor for CV disease

Back 12

homocysteine

Front 13

homocysteine causes damage to what?

Back 13

endothelium

Front 14

homocysteine has a role in formation of what?

Back 14

thrombi

Front 15

what levels of homocystein indicate a high risk of CV disease?

Back 15

>15 micromols/L

Front 16

hyperhomocysteinemia resulting from dietary deficiencies is treated with what supplements?

Back 16

folic acid, Vit. B6 & B12

Front 17

this blood study measures the peptide that when elevated - indicates presence of heart failure

Back 17

BNP

Front 18

when this peptide is elevated, it distinguishes between cardiac vs. respiratory causes of dyspnea

Back 18

BNP

Front 19

BNP levels should be what?

Back 19

<100

Front 20

infusion of what med will temporarily elevate BNP levels

Back 20

nesiritide (Natrecor)

Front 21

this is a noninvasive test that examines the lung fields & size of the heart by placing the patient in 2 upright positions - posteroanterior & lateral

Back 21

CXR (chest x-ray)

Front 22

when performing a CXR, you need to inquire of the patient these 2 things...

Back 22

1 - recent x-rays
2 - possibility of pregnancy

Front 23

this stdy records cardiac electrical activity for different views

Back 23

ECG

Front 24

this study can detect the rhythm of the heart, activity of pacemaker, conduction abnormalities, position of heart, size of atria and ventricles, presence of acute injury, and history of MI

Back 24

ECG

Front 25

a ____ - lead ECG is used w/ cardiac events

Back 25

12-lead

Front 26

what is important to instruct Pts about when having an ECG

Back 26

instruct them to avoid moving to decrease motion artifact

Front 27

a holter ECG monitor is usually worn for how long & corresponds to what?

Back 27

24-48 hrs & correlates rhythm changes with sympotoms recorded in a diary

Front 28

when wearing a holter ECG monitor, what kinds of activites should Pts do?

Back 28

normal activity is encouraged to simulate conditions that produce symptoms

Front 29

what instructions are important for RN to tell Pt about when wearing a holter ECG monitor

Back 29

keeping an accurate diary of activities & symptoms

Front 30

with holter monitors, how might men be affected vs. women

Back 30

shaving chest hairs to obtain good contact by electrodes might be an issue for men

Front 31

this test evaluates the effect of exercise tolerance on myocardial function

Back 31

exercise treadmill test

Front 32

with a treadmill test, continual monitoring of VS & ECG rhythms for ischemic changes are important for diagnosing what?

Back 32

left ventricular function and CAD

Front 33

if a Pt cannot walk on a treadmill, what equipment might be used to obtain same test?

Back 33

exercise bike

Front 34

what are the contraindications for an exercise treadmill test?

Back 34

any reasons a pt is unable to reach peak exercise

Front 35

when performing an exercise treadmill test, when are 12-lead ECGs obtained?

Back 35

before exercise, during each stage of exercise, and after exercise - until all changes have returned to normal

Front 36

this test is used to measure response to treatments and functional capacity for activities of daily living

Back 36

6 min walk test

Front 37

how fast should a Pt be encouraged to walk during a 6 min walk test

Back 37

as fast as possible

Front 38

this test uses ultrasound waves to records direction & flow of blood through the heart

Back 38

echocardiogram

Front 39

this test measures valvular abnormalities, congenital cardiac defects, wall motion, ejection fraction, and cardiac function

Back 39

echocardiogram

Front 40

what position will Pt be placed in for an echocardiogram?

Back 40

supine on left side

Front 41

what contraindications to an echocardiogram are there?

Back 41

none exist