ATI unit 4

Question 1

Creatine kinase MB

Answer 1

0% of total CK (30-170)

elevated 4-6hr after MI for 3 days

Question 2

Troponin T

Answer 2

Less than 0.2

elevated 3-5hr after MI for 2-3 weeks

Question 3

Troponin I

Answer 3

Less than 0.03

elevated 3hr after MI for 7-10days

Question 4

Myoglobin

Answer 4

Less than 90

elevated 2hr after MI for 1 day

Question 5

Total Cholesterol

Answer 5

Less than 200

Screening for heart disease

Question 6

HDL

Answer 6

females: 35-80
males: 35-65
good cholesterol produced by liver

Question 7

LDL

Answer 7

Less than 130

bad cholesterol can be up to 70% of total cholesterol

Question 8

Triglycerides

Answer 8

Females: 35-135
Males: 40-160
Over 65: 55-220
evaluating for atherosclerosis

Question 9

Echocardiogram

Answer 9

an ultrasound of the heart which is used to diagnose valve disorders and cardiomyopathy
Indications: Cardiomyopathy, heart failure, angina, MI
Noninvasive test that takes up to one hr
instruct patient to lie on left side and remain still

Question 10

Stress Test

Answer 10

The cardiac muscle is exercised by the patient walking on a treadmill, this provides info regarding the workload of the heart, Once the client’s heart rate reaches a certain rate the test is discontinued
Indications: Angina, HF, MI, dysrhythmia
Need informed consent
Pharm stress test- adenosine or dobutamine

Question 11

Hemodynamic monitoring

Answer 11

special indwelling catheters provide info about blood volume and perfusion, fluid status and how well the heart is pumping
Indications: serious illness, HF, CABG, ARDS, acute kidney injury, burn or trauma.
Need informed consent
Chest x-ray to confirm catherter placement

Question 12

Central Venous Pressure

Answer 12

1-8mmHg

Question 13

Cardiac output

Answer 13

4-7L/min

Question 14

cardiac catheterization

Answer 14

Invasive diagnostic procedure used to evaluate the presence and degree of coronary artery blockage
Indications: unstable angina and ECG changes, confirm and determine location and extent of heart disease
Need informed consent, NPO for at least 8 hours before procedure, ask about allergies bc of contrast dye used
Explain p/t is awake and sedated for procedure
Complications: cardiac taponade, hematoma formation, restenosis of treated vessel, retroperitoneal bleeding

Question 15

Cardiac tamponade

Answer 15

can result from fluid accumulation in pericaridal sac
Manifestations: hypotension, JVD, muffled heart sounds, and paradoxiacal pulse (variance of 10 mmHg or more in systolic bp between expiration and inspiration).

Question 16

Central catheters

Answer 16

appropriate for any fluids due to rapid hemodilution in the superior vena cava

Question 17

Nontunneled percutaneous central cath

Answer 17

15-20 cm in length with one to three lumens

short term use for blood administration, chemo drugs, parenternal nutrition, antibiotics

Question 18

Peripherally inserted central cath

Answer 18

40-65 cm with single or multiple lumens

Use for up to a year for blood administration, chemo drugs, parenternal nutrition, antibiotics

Question 19

Tunneled percutaneous central cath

Answer 19

48-104 cm in length

Long term use, need frequent vascular access

Question 20

Implanted port

Answer 20

surgically implanted into chest wall pocket, into subclavian vein with the tip in the superior vena cava
Long term need for vascular access; commonly used for chemotherapy