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PTRS 826 Exam 2 > Cardiac Stress Testing > Flashcards

Cardiac Stress Testing Flashcards

1
Q

Inpatient settings are more likely to use the _________ for assessment where outpatient settings are more likely to use ______.

A

6 MWT, GXT

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2
Q

____________ __________ in healthy individuals always needs to be looked into.

A

Abnormal, fatigue

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3
Q

Information from the EHR/Physician that is useful for assessment (5)

A
  1. Medical hx
  2. Physical exam (BP, cholesterol, hemat, electrolytes, ABG)
  3. PFT
  4. Previous GXT or EKG
  5. Body comp
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4
Q

List the information essential for conducting GXT (5)

A
  1. Medical hx
  2. Risk factor appraisal (CV risk screen)
  3. Level of supervision
  4. Absolute vs. relative contraindications
  5. Mode and extent of GXT
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5
Q

REVIEW CARDIOVASCULAR RISK SCREEN

A

YOU’LL DO IT

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6
Q

State the calculation for METS

A

VO2/3.5 = METS

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7
Q

List the components that are assessed with GXT (6)

A
  1. EKG [HR, ischemia, arrhythmia]
  2. VO2 max vs. peak [gas exchange]
  3. BP
  4. RPE [Angina/Dyspnea]
  5. Symptoms [Angina, dyspnea, claudication, non-cardiac limitation]
  6. Exercise capacity
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8
Q

List the ways in which stress testing can be used in cardiac patients (3)

A
  1. Diagnostic [no meds] for CAD - high risk for cardiac event
  2. Functional [with meds] - often for work clearance
  3. Therapeutic [w/w/o meds] - optimize medical management; what pt. can’t do
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9
Q

Data from GXT are your _________ to exercise progression.

A

limits

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10
Q

New York Heart Association Classification: Cardiac disease w/o limitations

A

Class I

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11
Q

New York Heart Association Classification: Cardiac disease slight limitation; PA results in fatigue, palpitations, SOBOE, angina

A

Class II

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12
Q

New York Heart Association Classification: Cardiac disease markled limitation; OK at rest, less than ordinary activity causes sx

A

Class III

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13
Q

New York Heart Association Classification: Cardiac disease but inability to perform PA w/o discomfot, Sx may be felt as rest and intensify w/activity

A

Class IV

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14
Q

List the New York Heart Association Classification that is the end goal for most cardiac patients.

A

Class II

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15
Q

With the 6 MWT you cannot rest in ____1____ during the test but you can rest in _____2_____ or ___3___ against a ___4___

A
  1. Sitting
  2. Standing
  3. Lean
  4. Wall
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16
Q

List the effect of the following medications on CHF

  1. Digoxin
  2. Diuretics
  3. Vasodilators
  4. ACE inhibitors
  5. Anti-arrhymthmics
A
  1. ST effect, may inc performance
  2. dec BP, inc performance
  3. inc HR, dec BP, inc performance [dec load on heart = higher work level]
  4. dec BP, inc performance
  5. may inc HR but little/no effect on performance
17
Q

With CHF ventilation/perfusion inequalities cause ____1____ ___2___ ____3____ and _____4_____/_____5_____. Ventilation/perfusion mismatch will limit _____6_____ ______7______. Those with CHF are also at increased risk of ______8_______.

A
  1. Increased
  2. Dead
  3. Space
  4. Hyperventilation
  5. Dyspnea
  6. Overall
  7. Performance
  8. Dysrhythmia
18
Q

List the PT essentials for MI (4)

A
  1. Have pt. keep NTG with during exercise
  2. Angina needs to be reported
  3. Always know what meds the pt. is taking [action and dosage]
  4. Monitor post-exercise recovery for 10 minutes [asx + HR<100 before leaving]
19
Q

Lower level exercise testing (GXT) in MI

A
  1. < 5 METS or considerably below anticipated peak
  2. Hemodynamics measures end of stage
  3. Assess functional status
  4. Promote client confidence and reassurance that normal activities can be understaken safely [fear is a major factor]
20
Q

Objectives of Stress Testing in MI (5)

A
  1. Chronotropic capacity and HR recovery [75-85% of capacity]
  2. Aerobic capacity [estimate]
  3. Myocardial aerobic capacity [i.e. RPP]
  4. Exertional symptoms [pain, SOB]
  5. Changes in electrical function
21
Q

Indicators of adverse prognosis with MI (4)

A
  1. Ischemic ST segment depression at low level exercise
  2. Fucntional capactiy < 5 METS
  3. Low peak RPP
  4. Hypotensive BP response to exercise
22
Q

Special considerations for MI GXT (4)

A
  1. Pt. w/PAD or DM2 have specific precautions
  2. Select equipment adjusted by 1 MET increments
  3. Minimum frequency of training = 3 nonconsecutive x/wk
  4. Safey Edu: monitor sx, medication, ADLs/return to work
23
Q

Describe why you shouldn’t check one’s pulse over their carotids

A

If you push on the carotids too hard you can’t feel a pulse. Additionally, pushing on the carotids effects the baroreceptors and can increase HR.

24
Q

List reasons why it’s important to understand the numbers from stress testting (3)

A
  1. Disease dx
  2. Prevention of complications
  3. Assist in monitoring progress/decline
25
Q

Describe what BUN and Creatine assess

A

Both look at kidney function

26
Q

For CK list the

  1. Onset
  2. Peak
  3. Return to Normal
A
  1. 3-4 hr
  2. 33 hr
  3. 3 days
27
Q

For troponin list the

  1. Onset
  2. Peak
  3. Return to Normal
A
  1. 3-12 hr
  2. 18-24 hr
  3. Up to 10 days
28
Q

For myoglobin list the

  1. Onset
  2. Peak
  3. Return to Normal
A
  1. 1-4 hr
  2. 3-15 hr
  3. –
29
Q

For LDH list the

  1. Onset
  2. Peak
  3. Return to Normal
A
  1. 12-24 hr
  2. 72 hr
  3. 5-14 days
30
Q

List normal values for

  1. HDL
  2. LDL
  3. Total Cholesterol
A
  1. > 40
  2. < 100
  3. < 200
31
Q

List the normal hemoglobin values for

  1. Women
  2. Men
A
  1. 12-15.8g/100 mL
  2. 13.3-16.2g/100 mL
32
Q

Define hematocrit and list the normal values for

  1. Women
  2. Men
A

Percent of blood that is cells; viscosity

  1. 38-47%
  2. 35-44%
33
Q

List normal values for WBC

A

4500-11,000/micro L of whole blood

34
Q

______ levels of hemoglobin and _______ blodd increases the stress on the heart.

A

Low, thick

35
Q

List normal values for

  1. BUN
  2. Creatine
A
  1. 8-18 mg/dL (high = heart/renal failure; urea retention)
  2. < 1.5 mg/dL (> 4.0 = renal failure)
36
Q

List the following fasting serum glucose values

  1. Normal
  2. Insulin Resistant/Pre-Diabetes
  3. Diabetes
A
  1. 70-100 mg/dL
  2. 100-125 mg/dL
  3. > 126 mg/dL
37
Q

PET scans have ___1__ false positives and are very ____2____ in detetcing heart problems. PETs can be used to assess _____3_____ ___4___ ___5___. and detect ____6____.

A
  1. Low
  2. Accurate
  3. Coronary
  4. Blood
  5. Flow
  6. Stenosis
38
Q

With SPECT a camera rotates __1__ degrees. This test can be used to detect ____2____ or _____3_____. If the space is gone after rest = ____4____. If the space is seen after rest = _____5_____.

A
  1. 360
  2. Ischemia
  3. Infarction
  4. Ischemia
  5. Infarction

PTRS 826 Exam 2 (10 decks)

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