ECG/ Leads
This is the first wave seen that represents the depolarization of the atria. It should always be before a QRS complex
What is: P Wave
An echocardiogram (ECHO) measures the ejection fraction and examines the size, shapes, and motion of cardiac structures. These are the two types of ECHOs.
What are:
1) Transthoracic Echocardiogram (TTE)
2) Transesophageal Echocardiography (TEE)
This type of catheterization is performed to assess the function of the tricuspid and pulmonary valves.
What is: Right Heart Catherization
Exercise stress testing requires the patient to run or bike to achieve a target heart rate, but it's important to stop at this point of the test.
What is: when the patient experiences signs of myocardial ischemia (chest pain, ST segment depression, ventricular arrhythmias)
These two sites can be used for cardiac catheterization.
What are: groin area and wrist
In a 12 lead ECG, electrodes are placed in these two sites.
Considering that the transesophageal echocardiogram requires an endoscope to be inserted down the esophagus, these two substances are applied prior to the procedure to reduce discomfort associated with the transducer position.
What are:
1) anesthetic agents
2) sedatives
Cardiac catheterization involves this kind of insertion and type of catheter.
What is:
1) percutaneous
2) radiopaque catheters
This type of stress test is for patients who can't follow directions or have physical disabilities that prevent them from reaching their target HR on a treadmill or bike.
What is: Pharmacologic stress testing
Considering that isotopes are used in a multiple-gated acquisition (MUGA) procedure, you provide your patient with this teaching for their post-op care.
What is: encouraging increased intake of fluids to flush out isotope
What is: myocardial ischemia
Proper assessment must be done for history of these two things as they increase one's risk for complications during procedure.
1) dysphagia
2) radiation therapy
What is: 8 to 12 hours before procedure
For exercise stress testing, HCPs may hold these three medications for up to 48 hours before the stress test because they may interfere with the stress test results.
What are: beta-blockers, calcium channel blockers, and digoxin
Electrodes should be changed this often to examine the skin for irritation and apply electrodes to different locations
What is: 24 hrs
ECG implementation requires these 4 nursing interventions to help minimize things that compromise conduction to get a more reliable read
What is:
1) removing hair (use electric clippers)
2) rub site with alcohol pad
3) rub site with 2x2 gauze
4) place electrode (ensure adequate gel)
What is: sore throat may be present post procedure for 24 hours
Patients are at increased risk for contrast-induced nephropathy (CIN) due to cardiac catheterizations. Because of this, it's important to monitor any elevations in this lab value.
What is: Serum creatinine
You have a patient scheduled for a pharmacologic stress test and they report to you that they drank coffee this morning, so you must perform this nursing action
What is: reschedule the teset
Your patient is scheduled for pharmacologic stress testing. Considering that the doctor also wants to perform an echocardiogram, you're ordered to use this pharmacologic substance for the pharmacologic stress test as it altered the myocardial wall motion because the substance enhances contractility.
What is: Dobutamine
To ensure safety, patients must be informed of ECG purpose and these 2 primary ACS (acute coronary syndrome) symptoms.
What is:
1) SOB
2) Chest pain
Patients undergoing a transesophageal echocardiogram may have a sore throat post procedure for 24 hours, but they should report these three symptoms to their nurse/ provider.
1) persistent sore throat
2) SOB
3) difficulty swallowing
Bleeding may occur during cardiac catheterization. If bleeding occurs, you perform these interventions.
What is: sitting (wrist) or lie down (groin) and apply firm pressure to the puncture site for 10 minutes and notify HCP asap
What is: notifying the PCP
Because bleeding and hematoma formation are procedural risks in cardiac catheterization, these three lab values should be taken at baseline and later compared with post-procedure results to monitor for blood loss.
What are: Hct, Hgb, PLT