TAVR
What does TAVR stand for?
Transcatheter Aortic Valve Replacement
Greater saphenous vein in the leg
Mammary artery
(radial artery)
What are the default HR settings for a patient requiring telemetry monitoring?
50-120
You are hanging a new bag of heparin with no rate change. What do you need to do?
Get a second RN to verify the right patient, right drug, right dose, right route, right time.
During cardiac catheterization for TAVR approach, which arteries are often used?
Radial, femoral and sometimes subclavian
When is the aquacel dressing removed on a post CABG patient?
4 - 7 days.
How often are telemetry strips printed for IMC patients?
Every 4 hours.
You and the previous shift RN bladder scanned your patient 3x, and each time you straight cathed with >400ml urine output. It's now 4 hours later and your patient has not yet voided on her own. What is your next action.
Bladder scan the patient and call the provider to determine if they want to straight cath again or order an indwelling urinary catheter.
Which tests are done prior to TAVR?
Echocardiogram
CT angiogram
Cardiac Cath
Labs
EKG
Chest tubes are typically discontinued when CT output is less than how much after 24 hours?
240 ml
What is documented on your telemetry strip/in EPIC?
PR interval
QRS interval
QT interval
You received an order to place a nasogastric tube in your patient because they failed their swallowing evaluation. How to you measure the correct placement?
Tip of nose, to the ear, then to the xiphoid process. Mark the location.
Name at least 3 potential complications that may occur after TAVR?
Stroke
Hematoma/bleeding
Pacemaker
You have an order to split your patient's chest tubes. which chest tube is isolated to it's own pleura-vac?
Right pleural and mediastinal are on one pleura-vac; left pleural is isolated by itself to a separate pleura-vac.
The default alarm limits are 50-120, but your patient keeps alarming with a HR of 48 and is asymptomatic and sleeping. What do you do?
What complications would you potentially anticipate for the patient post TTVR?
Cardiac Conduction delays, PVCs as this is a right-sided approach.
Describe at least 5 post procedure orders that you would anticipate for your TAVR patient?
Avoid bending for 3 days
No driving for 1 week
No lifting/pulling anything heavier than 10lbs for 2weeks
Shower 24 hours after the procedure - no powder or lotions
What is ERAS? Why is this used?
Enhanced Recovery after Surgery
Multi-modal analgesia (non-narcotic)
Early mobility/eating/bowel motility/voiding
Cough/Deep breathing/IS
You want to cross-check that you are safely administering IV amiodarone and that it is compatible with a heparin drip. What should you do?
On the Bridge, check the IV drug administration guidelines and IV compatibility chart.
Your post-CABG patient is tachycardic, anxious, b/p is 80/40 and you auscultate muffled heart sounds. What complication could be occurring and what is your next action?
Cardiac tamponade; Call the cardiac alert/medical emergency response team/alert CTS; prepare for open chest procedure.