12 Lead EKG Test
What does noninvasive mean?
nothing will go in the pt's body
During this test, a harmless radioactive substance called a tracer is injected into the pt's blood stream.
Nuclear stress test
What is the purpose of a stress loop?
Reduces tension placed on the electrodes by the pt's movements
What does EHR stand for?
Electronic Health Record
What should you do with the EKG machine after use?
Clean and store the machine- includes cleaning the electrode clips and lead wires
What identifiable information should you ask prior to starting the test?
name and DOB
What is the purpose of stress testing?
Evaluates how the heart functions under controlled stress.
How does an ambulatory monitor differ from a resting EKG?
ambulatory monitors allow doctors to evaluate cardiac activity over longer periods of time with varying activity levels
What is PHI and what does it include?
Protected Health Information- pt's name, address, telephone number, social security number
In order for a stress test to be valid, the pt must reach a HR that is ____% of the age-predicted maximal HR.
85
What should you do if you are conducting a test on a person with developmental disabilities?
-treat them as adults, parents/caregivers should be allowed to stay in the room, ensure communication aids are in place prior to starting the test, the tech should ask for consent before any physical contact
What are 3 ways in which cardiac stress can be induced during a stress test?
Treadmill, bike, stimulant medications
How many electrodes do most ambulatory monitors have?
5 electrodes
This is a federal law that addresses how a pt's medical info can be collected, viewed, and shared.
HIPAA
Calculate the maximal HR for a 37 year old pt.
155 bpm
If you are conducting an EKG on a child, what might you tell them?
-all same info as adults but in age appropriate language, does not hurt, no needles
Before the initial resting EKG is done during a stress test, what must the pt do?
Lie in supine position with arms above the head
How long do Holter monitors record cardiac activity for?
24-48 hrs
What does the EKG tech have to do if the EKG machine does not automatically upload the EKG to the pt's chart?
manually upload the EKG according to the facility policy.
The pt has a maximal HR of 138. What does this mean?
This means the pt's HR must reach 138 during the stress test in order for it to be valid.
What information should be conveyed to a pt prior to the start of a 12-lead EKG?
-test is noninvasive, painless, male pts may need to trim body hair, the test is over quickly, the test gives the doctor important info about the heart's rate and rhythm
Describe the instructions that you would give to a pt prior to a stress test.
-avoid caffeine for 24 hrs prior to the test, follow the doctor's instructions regarding meds, do not eat/drink anything besides water for 3 hrs prior to the test, wear comfortable clothes and sneakers, bring all meds with you, the entire test will last 2-4 hrs
Instructions provided to pts with ambulatory monitoring include:
-do not remove the lead wires, do not get the monitor wet, continue normal activities, keep an activity diary with symptom onset, call 911 for severe chest pain or SOB, return all equipment when testing is complete
What are some tips for computer based documentation?
-keep passwords secure, log out of the computer after use, allow access to records on a need to know basis, be aware of who the pt authorized to see information
A stress test should be stopped immediately if:
dizziness, chest pain, SOB, sudden increase/decrease in BP, SBP>250, DBP>115, leg cramps, severe fatigue, severe diaphoresis, ST segment changes, worsening or dangerous dysrhythmias, HR does not rise above 120