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20 Cards in this Set
- Front
- Back
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EKG/ECG: Telemetry How many leads? What does it tell us? What does it not tell us? Teaching? |
-3 or more leads (1 electrical axis) -tell us if there electrical conduction, does NOT tell us how the heart muscle is responding to the electrical conduction -not allowed to shower while wearing monitor |
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EKG/ECG: Holter Monitoring How many leads? How long is the rhythm recorded? What can it tell us? Teaching? |
-5 leads -recorded over 48-72 hours (3 days) -can tell us what is possibly causing abnormal rhythm -perform normal activities -keep activity diary -no showering or removal of electrodes...may sponge bath |
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Echocardiogram what type of test? what does it tell us? |
-sound wave test -tells us size of heart, valve function, other heart structures -gives us a visual of the heart |
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Transesophageal Echo How does it differ form a regular echo? Procedure and length to time? Teaching? Post procedure? |
-emits sound waves across the esophagus -swallow flexible rubber tube w/transducer at the end until it is behind the heart -usually sedate them with versed or hurricane spray -turned on L side and remove dentures -takes about 30 min. Teach: NPO 4-6 hours before test, no eating and drinking until gag reflex returns |
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Cardiac Nuclear Scanning what does it determine? Cold spots/good tissue appears? Hot spots/bad tissue appears? Procedure and length of time? |
-blood flow through coronary artery and pumping ability of heart muscle -*they just tell us there is a problem...may have to do a cardiac cath afterwards -inject radioactive material into vein through an IV and heart scanned -thallium 201 appears with in good heart muscle, shows "cold spots" -technetium 99 appears in bad heart muscles, shows "hot spots" -takes a long time compared to TEE (1.5-2 hours) |
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Exercise Stress Test (treadmill/bike) Teaching? How many leads placed on chest? What vitals do you check during exercise? Nursing Role..what do you check? What does it determine? |
-NPO at least 2 hours prior/wear comfortable clothing and walking shoes -5-10 electrodes placed on chest -check BP and HR during -check to see if certain meds should be held...ie. cardiac meds -determines need for cardiac cath, exercise tolerance after an MI or heart surgery |
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Exercise Stress Test (thallium or sestamibi) whats the difference? what is it used for? what does low uptake indicate? procedure? |
-same as treadmill but with injection of dye -determine blood flow through coronary arteries during exercise in person suspected or know CAD -low uptake indicates regions of ischemia we want high uptake of the dye -inject dye in IV hour prior to pictures. after pictures pt. will exercise, then more dye and pictures taken -comparison of before and after exercise to determine if heart muscle getting enough blood supply |
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Pharmacological Stress test (no exercise) Teaching? Who is for? |
-for people who are unable to walk on a treadmill..maybe they have really bad COPD or knee replacement -NO smoking or caffeinated drinks night before the test -NPO after midnight before the test -thallium or sestamibi injected one hour before pictures taken |
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Cardiopulmoary Exercise Test Procedure? What does it determine? |
-hold mouth piece while exercising -machine collects inhaled and exhaled air -measures CO2 and O2 -determines how much activity body can handle before feeling of fatigue begins |
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Electrophysiological Study (EPS) What does it determine? Process? What are we concerned about? Pt. Prep? What is an important question to ask? Post procedure? What important med do we give during? ~story Pam told about pt. who they couldn't get to go into the rhythm and he could feel when he was in the rhythm |
-where in the heart muscle is causing ectopic rhythm -up femoral vein into the right atrium -ablation (freeze or burn areas of the heart) -concerned about damaging SA node or pathway between SA to AV node -"when was the last time you took your cardiac meds?"....you don't want to take them. hold them -similar to cardiac cath (NPO prior) -pt.is awake -give sedative or anti-anxiety med -IV heparin during procedure....don't want a clot to form -Post: check for signs of DVT, bedrest for 4-6 hours), check leg for hematoma, bleeding, pulses, signs of decreased perfusion or thromboembolism -hospitalized for at least 24 hours w/cardiac monitoring |
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Where is the SA node located? |
In the Right Atrial wall -why we are concerned about damaging it during a EPS |
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Cardiac Output: what is it? Formula? Normal Range? |
-amount of blood in Liters ejected from L ventricle each min -CO= SV x HR - 4-8 L/min if your heart rate decreases....so does your CO |
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Stroke Volume What 3 things effect SV? |
-amount of blood ejected per ventricular contraction - Preload, afterload, and contractility |
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Cardiac Index -why is it a better determinant of perfusion? -Range? |
-it takes into consideration a person's size when looking at perfusion - 2.8-4.2...basically less than 3 we are worry |
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Pre-load -think of it as what? -what is it effected by? -How do we measure it? -What causes increased preload? decreased? |
-"fluid"...amount of stretch before systole -effected by the vol. at the end of diastole...associated with end diastolic pressure -measure it with Central Venus Pressure ( R sided preload) and Wedge pressure/PAOP (left-side pre-load) -Increased: fluid overload, vasoconstriction -Decreased: dehydration, vasodilation |
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Afterload: -what is it? -what is the most critical factor? -How does it effect SV |
-amount of resistance the ventricles must overcome in order to eject blood -***vascular resistance is the most critical factor -effects stroke vol. by increasing or decreasing the ease of emptying a ventricle during systole |
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What is normal PR interval? which AV block has a increased PR interval? |
-.12-.2 -1st degree AV block |
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What is normal QRS interval |
.04-.12 |
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What does ST elevation mean? Depression? |
-Elevation means infarction & injury -Depression means ischemia |
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What does a prolonged QT interval mean? |
can precede a LIFE THREATENING ARRHYTHMIA |
