10 minute topic Cardiovascular diagnostics and Procedures

Question 1

When are Cardiac enzymes released?

Answer 1

hen the heart muscle suffers ischemia

the heart isn’t getting enough oxygen

Question 2

When is a lipid profile used

Answer 2

detects cholesterol levels and is used for early detection of heart disease

Question 3

Indications for running cardiac enzyme or lipid tests

Answer 3

Angina
MI – s/s of MI
Heart disease – a patient with known heart disease and comes in with other s/s
Hyperlipidemia

Question 4

CK-MB range

Answer 4

30-170 but really should be 0

Question 5

CK-MB time of elevation

Answer 5

elevates within 4-6 hours of myocardial injury

stays elevated for 3 days

Question 6

Troponin T range

Answer 6

<0.2ng/L

Question 7

Troponin T time of elevation

Answer 7

elevates within 3 hours of MI

stays elevated for 2-3 weeks

Question 8

Troponin I range

Answer 8

0.03 ng/L

Question 9

Troponin I time of elevation

Answer 9

elevates within 3 hours of MI

Stays elevated for 10 days

Question 10

Myoglobin range

Answer 10

<90mcg/L

Question 11

Myoglobin time of elevation

Answer 11

elevates within 2 hours of MI

Only stays elevated for 24 hours

Question 12

HDL ranges

Answer 12

35-65mg/dl for men

35-80 mg/dl for women

Question 13

LDL cholesterol levels

Answer 13

<130-180 mg/dl

Question 14

Triglycerides

Answer 14

should be <150

used to evaluate for atherosclerosis

Question 15

Echocardiogram

Answer 15

ultrasound of the heart used to dx valve disorders

looking at the actual structure of the heart

Question 16

Candidates for an ECG

Answer 16

cardiomyopathy
HF
angina
MI

Question 17

Pharmalogical stress test

Answer 17

Adenosine is given if PT is unable to walk on treadmill

Question 18

Stress test candidates

Answer 18

Angina
heart failure
MI
dysrhythmias

Question 19

Cardiac Angiography (AKA cardiac catheterization)

Answer 19

invasive diagnostic procedure to evaluate the presence and degree of coronary artery blockage

Question 20

Cardiac Angiography (AKA cardiac catheterization) procedure

Answer 20

occlusions are seen by injecting contrast media under fluoroscopy

Question 21

Cardiac Angiography (AKA cardiac catheterization) indications

Answer 21

unstable angina w/ ECG changes

to determine extent and location of known heart disease

Question 22

Cardiac Angiography (AKA cardiac catheterization) pre-procedure

Answer 22

NPO for 8 hours due to aspiration risk
Check BUN and creatanine because the dye is excreted through the kidneys
check for shellfish or iodine allergy

Question 23

Cardiac Angiography (AKA cardiac catheterization) intra procedure

Answer 23

client is awake
local anesthetic
client will feel warm flushing
pressure to be placed on incision to prevent bleeding

Question 24

Cardiac Angiography (AKA cardiac catheterization) post procedure

Answer 24

monitor pedal pulses
we are on the arterial side so a clot would go toward to feet
Supine position
Continuous cardiac monitoring

Question 25

Cardiac Angiography (AKA cardiac catheterization) patient teaching

Answer 25

avoid strenuous activity for 4-6 days Report bleeding, SOB, changes to extremity have regular labs if on coumadin

Question 26

Cardiac Angiography (AKA cardiac catheterization) complications

Answer 26

cardiac tamponade Hematoma Re-stenosis of treated vessel retroperitoneal bleeding

Question 27

cardiac tamponade

Answer 27

fluid accumulation in the pericardial sac This is a cardiac emergency and they will do a pericardiocentesis Give IV fluids to combat hypotension

Question 28

cardiac tamponade s/sx

Answer 28

include hypotension, jugular venous distention, heart sounds will be muffled, paradoxical pulse and BP change of inhalation and exhalation

Question 29

Re-stenosis of treated vessel

Answer 29

Clot reformation Can occur immediately or several weeks after procedure Pattern changes in the ECG and possible chest pain Notify the MD They will go back to the cath lab

Question 30

retroperitoneal bleeding

Answer 30

Bleeding into retroperitoneal space (abdominal cavity behind the peritoneum)

Question 31

Cause of retroperitoneal bleeding

Answer 31

femoral artery puncture

Question 32

Retroperitoneal bleeding sx

Answer 32

Flank pain | hypotension

Question 33

Retroperitoneal bleeding tx

Answer 33

give IV fluids and blood Notify MD Surgical repair required this is an emergency