Cardiac Assessment

Question 0

Explain cardiac catheterization?

Answer 0

Puncture in the femoral or radial artery with a long catheter. Advance it to the heart, contrast is injected to provide info about the status of the coronary arteries, ventricular function, valve dz, and intra cardiac pressures. Will feel a warm sensation when dye is injected.

Question 1

In cardiac catherization, what does this test tell us?

Answer 1

The function of the heart blood flow in the coronary arteries….how well the heart muscle is being oxygenated.

Question 2

What are the pre-procedure nursing considerations for cardiac catherterization? .

Answer 2

Consent signed
NPO 6 hrs
Kidney function test
Check allergies to shellfish and iodine.
Empty bladder
Check distal pulses for comparison post

Question 3

What are the post procedure considerations for cardiac catheterization?

Answer 3

VS, assess distal pulses
Monitor site for bleeding
Maintain IV fluids
Lay flat with pressure on site for 8 hours with femoral.

Question 4

Nursing considerations if the radial artery was used for cardiac cath?

Answer 4

Can get up and move
CMS checks in that hand
Shorter recovery time

Question 5

What is an ambulatory ECG?

Answer 5

Holster monitor

Question 6

What are the instructions for a holter monitor?

Answer 6

Done for 24 hrs, normal activity. No shower or bath.

Keep a diary of all activities and symptoms

Question 7

What does the exercise treadmill test?

Answer 7

The effect of stress on heart function. Continuous EKG and VS for ischemic changes.
Wear comfortable clothes and shoes
Report any symptoms

Question 8

What does a echocardiogram look at?

Answer 8

involves ultrasound of heart that records direction and flow of blood through the heart.
Measures valvular abnormalities, congenital cardiac defects and cardiac function.
Calculates ejection fraction

Question 9

What is the difference in echocardiograms?
Transthoracic echo TTE

Transesophageal echo TEE
Stress echo

Answer 9

TTE is just an ultrasound of chest
TEE goes down the esophagus, invasive, NPO, local anesthetic
Position for both is laying down, maybe left lateral to bring heart closer to chest.

Question 10

Why do a nuclear cardiology test?

Answer 10

IV injection of a radioactive isotope used to evaluate contractility and perfusion

Question 11

What are the pre procedure instructions for a nuclear cardiology test?

Answer 11

Light meal and regular meds except for things that change the heart functions; caffeine, albuterol etc.

Question 12

What is involved with a electrophysiology study (EPS)?

Answer 12

Records intra cardiac electrical activity. Uses catheters inserted in the femoral vein and right atrium.

Question 13

What are the pre procedure nursing responsibilities for EPS?

Answer 13

Ensure consent is signed
Cardiac meds may be with held
Keep pt NPO 6-8 hrs
Premedicate for relaxation

Question 14

When assessing the heart, what is the objective data you want to collect in regards to oxygen?

Answer 14

Cardiac rhythm
Heart sounds-regular?irregular?( S1 m+T valves at the end of systole)
(S2 A+P valves at the end of ventricular systole and signals the beginning of ventricular diastole, upper rt and lft 2nd intercostals)
Assess orthostatic hypotension
-apical-radial pulse deficits
Assess peripheral pulse deficit
Assess peripheral pulses
Assess color, temperature and cap refill of extremities.
WOB, SpO2, skin color, ascult lungs

Question 15

What are some subjective questions you can ask about symptoms in regards to oxygen?

Answer 15

Any palpitations
Hx of syncope
Dyspnea

Question 16

What is Orthopnea?

Answer 16

Have to sit up to breath

Question 17

What is PND paroxysmal Nocturnal Dyspnea?

Answer 17

Can’t lay down, heart can’t handle the volume of blood from feet and legs being elevated.

Question 18

What are the chief complaints when a person is giving you subjective data on rest/sleep /and comfort?..what should you ask them

Answer 18

O- onset of symptoms-when did it start
P- precipitating event-what were you doing
Q- quality-is the pain dull, aching,sharp
R- radiating-is it going up arms or legs
S- severity- how bad is it 0-10
T- timing- did it change over time or stay the same
Avoid the use of the word pain, use discomfort, pressure.

Question 19

How do women’s symptoms differ than men’s for cardiac problems?

Answer 19

Back pain
GERD
Jaw pain
Arm pain
Fatigue
N/V
Diaphoresis
Tired, can't catch breath

Question 20

How do you assess fluid intake and urinary retention in regards to cardiac problems?

Answer 20

Assess for c/o weight gain-monitor lung sounds
Edema-JVD? Ask if shoes too tight or socks too tight, what level of edema?
Nutritional intake- daily weight and assess urinary output and I+O

Question 21

Where do the black and red leads go?

Answer 21

Black-LA

Red- LL

Question 22

Where do the white, grew, and brown leads go?

Answer 22

White- RA
Green-RL
Brown- 4th intercostal space right side

Question 23

How often are electrodes replaced?

Answer 23

Every 48hrs or as needed.

Question 24

How often are leads checked?

Answer 24

Should be checked at least qday

Question 25

What are the nursing responsibilities when performing a 12 lead EKG?

Answer 25

Ensure good contact between electrode and skin
Skin is clean and dry
Put underneath breast tissue
Check expiration of gel pads, dry will not conduct
Ask if any skin irritations or allergies to adhesive tapes.
Check to see that arms and legs are not touching.

Question 26

What additional steps are required when preparing a child for cardiac catheterization?

Answer 26

Weight and height for length of catheter and dose of meds
No femoral access If diaper rash
Radial artery is not big enough

Question 27

When a child is placed NPO for catheterization(cardiac), what must the RN assess for?

Answer 27

NPO for a few hrs
Check BG level, HR is increased if hypoglycemia
Check VS,
Start IV D5W