Cardio Labs / Diagnostics

Question 1

1) Troponin 1 is an example of what?
2) What is a series of radiographs taken after contrast medium is injected into a vein or artery? It Can also be called “Cardiac Catheterization?”

Answer 1

1) A cardiac marker
2) angiogram aka angiography aka cardiac catherization
USES CONTRAST WHICH ENABLES VISUALIZATION OF BLOOD FLOW WITHIN THE CORONARY CIRCULATION.

CHECK FOR ALLERGIES- IODINE AND SEAFOOD

Question 2

WHAT IS AN Invasive procedure that is used to visualize heart chambers, valves, great vessels and coronary arteries? It can reveal heart abnormalities such as obstructions

Answer 2

Cardiac catheterization
KNOW: IT IS A STERILE PROCEDURE
KNOW: ASSESS FOR IODINE ALLERGIES
KNOW: Have patient rest in bed for 2 to 6 hours after procedure TO PREVENT BLEEDING

Question 3

FOR A PATIENT PRIOR TO AN ANGIOGRAM, WHAT SHOULD YOU ASSESS?
FOR A PATIENT AFTER AN ANGIOGRAM, WHAT SHOULD YOU ASSESS?

Answer 3

PRIOR- DYE ALLERGIES
POST- • Check site (usually the groin area) for excessive bleeding, compression device is in place
• Checks pulses below the site –check pedal pulses if femoral site was used for the procedure

Question 4

1) FOR AN Angiogram (Catheterization) WHAT ARE TWO THINGS TO MONITOR?

2) For cardiac catheterization on left antecubital insertion site, palpate ______ ______ (distal pulse) on left arm after procedure to evaluate thrombophlebitis and vessel occlusion.

Answer 4

1) monitor for- bleeding s/p procedure
monitor pedal pulses every 15 minutes and palpate distal pulse and compare with baseline

2) PALPATE RADIAL PULSE

Question 5

Location of the apical pulse?
LOCATION OF THE DORSAL PULSE?
LOCATION OF THE POSTERIOR TIBIAL PULSE?

Answer 5

BETWEEN 5TH INTERCOSTAL SPACE, LEFT
TOP OF THE FOOT
INSIDE OF ANKLE

Question 6

What measures changes in volume in different areas of your body? It measures these changes with blood pressure cuffs or other sensors. These are attached to a machine called a ________.
It is effective in determining if there is a blood clot in the arm or leg.

Answer 6

Plethysmography
Plethysmograph

Question 7

What device is used to locate a weak pulse?

Answer 7

Doppler
Doppler is used to HEAR THE PULSE IN AN ARTERY
AN ULTRASOUND IS USED TO VISUALIZE THE BLOOD FLOW W/IN A VASCULAR SYSTEM.

Question 8

LAB VALUES;
Platelets….
What do they do?

Answer 8

150,000-400,000
Platelets promote clot formation.
Thrombocytopenia= decreased count
Thrombocythemia= increased count

Question 9

WBC….
RBC….blood
Hemoglobin (Hgb)…..
Hematocrit (HCT)… sufficient RBC to carry O2

Answer 9

WBC-5,000- 10,000
RBC - 4.5 - 5.5
Hgb - 12-18
HCT - 37% - 50%

Question 10

Differential count: READ AND GIVE THE PERCENTAGES OF EACH:

Neutrophils— anti-inflammatory response
Lymphocytes— increase with bacterial and virus infections
Monocytes— found in bloodstream as phagocytic, when in tissue become macrophages
Eosinophils— parasitic infections

Answer 10

Neutrophils- 50% to 70%
Lymphocytes- 20% to 40%
Monocytes- 4% to 8 %
Eosinophils- 2% to 4%
NEVER LET MONKEYS EAT BANANAS (basophils)

Question 11

1) What can relieve some arrhythmia symptoms, such as fatigue and fainting, and help a person who has abnormal heart rhythms?

Answer 11

Pacemaker

Question 12

What is the surgical intervention for Angina pectoris?
If patient develops pain after the procedure- what should you do?

Answer 12

CABG—Coronary Artery Bypass Graft
Report info to MD STAT

Question 13

DEFINE ANGIOPLASTY.

Answer 13

SURGICAL REPAIR OR UNBLOCKING OF A BLOOD VESSEL, ESPECIALLY A CORONARY ARTERY

Question 14

Grafts are usually taken from sections of saphenous veins in the legs or in the internal mammary arterY FOR WHAT PROCEDURE?

Answer 14

CABG
CORONARY ARTERY BYPASS GRAFT

Question 15

AFTER A CABG; IF THE PATIENT HAS AN IRREGULAR PULSE- WHAT SHOULD YOU DO?

Answer 15

Count apical pulse for 1 minute if patient has irregular radial pulse

Question 16

Serum cardiac markers ALL ELEVATED WITH AN MI:
CK-MB– Creatinine Phosphokinase CPK- when does this value PEAK?? RETURN TO NORMAL?
troponin
SGOT
LDL
WHAT ARE THE NORMAL RANGES FOR EACH?

Answer 16

CK-MB- Normal = 25-200 CPK, 0-4 MB
PEAKS IN 24 HOURS, RETURNS TO NORMAL 24-40 WITHIN HOURS
Troponin = < 0.04
SGOT = 10-42 U/L
LDL = 140-280 U/L

Question 17

THIS cardiac marker is noted as Levels which rise 4 to 8 hours after an acute MI,
Peaks at 16 to 24 hours
Returns to baseline within 4 days.
Monitor patient for 24 hours
•25-200 U/L
•32-150 U/L
NAME THE CARDIAC MARKER.

Answer 17

Creatine Kinase (CK)

Question 18

THIS cardiac marker begins to increase 6 to 10 hours after an acute MI
Peaks in 24 hours
Remains elevated for up to 72 hours.
•< 12 IU/L if total CK is <400 IU/L
•<3.5% of total CK if total CK is >400 IU/L
Which cardiac marker does this describe?

Answer 18

CK-MB CK ISOENZYME

Question 19

What cardiac marker is useful in diagnosing MI? Its level rises in 3 hours after MI, peaks 14 to 18 hours and returns to normal in 5 to 7 days. It has a normal range of > 0.04

Answer 19

Troponin - myocardial muscle proteins released in circulation after myocardial injury.

Question 20

SGOT (serum glutamic oxaloacetic transaminase) - will begin to rise in 8-12 hours and peak in 18-30 hours
• What is its normal U/L range?

Answer 20

10 to 42 U/L

Question 21

Name the hormone that is secreted by the heart in response to ventricular expansion and pressure overload? It is a Marker for HF – “stretch” of heart during contraction and IF ITS LAB VALUES ARE above 100 pg/ml, THIS indicates HF.

Answer 21

BNP- B type Natriuretic Peptide

Question 22

CHECK ALL THAT APPLY…Elevated lab values on myocardial infarction: (4)

Answer 22

•SGOT / AST
•CPK-MB
•LDH
•Troponin

Question 23

WHAT IS THE RECOMMEND AMOUT OF SODIUM INTAKE PER DAY?
ANSWER IN MG AND TEASPOON

Answer 23

2,300 MG/ DAY WHICH IS (1) TEASPOON

Question 24

The Medicinal management for HEART FAILURE IS TO INCREASE CARDIAC EFFICIENCY
BELOW ARE THE MEDS: WHAT are THEIR PURPOSES IN HELPING A HF PATIENT?
• Digitalis- Digoxin= _________
• Vasodilators = ________
• ACE inhibitors = ___________
+ DIURETICS= _______

Answer 24

• Digitalis- Digoxin (strengthens heart contraction)
• Vasodilators (makes vascular bed larger)
• ACE inhibitors (decreases blood pressure)
+ DIURETICS= Decrease fluid volume

Question 25

Assessment Essentials:
• “What you can see, hear, feel, smell, or touch”
• Vital signs
• Physical assessment
• Diagnostic results
• Vomiting
• Diaphoresis
• Cardiac Rhythm changes
• ABCs 1st priority

Answer 25

Objective data

Question 26

WHAT IS CALLED THE difference between the radial and apical pulse?

Answer 26

PULSE DEFICIT

HAPPENS WITH ATRIAL FIBRILLATION AND ATRIAL FLUTTER

Question 27

Ischemia is insufficient blood flow to provide adequate oxygenation. This leads to tissue hypoxia (reduced oxygen)
Ischemia always results in hypoxia; however, hypoxia can occur without ischemia if, for example, the oxygen content of the arterial blood decreases as occurs with anemia.

Answer 27

ISCHEMIA NOT ENOUGH BLOOD FLOW TO PROVIDE O2.
ISCHEMIA ALWAYS RESULTS IN = HYPOXIA
HYPOXIA NOT ENOUGH O2 IN TISSUE

Question 28

What is weakness of the legs accompanied by cramplike pains in the calves caused by poor circulation of the arterial blood to the leg muscles?

Answer 28

Intermittent claudication

It is a common manifestation of peripheral arterial disease (PAD)

Question 29

• = Pulses (assess all pulses)
• = Appearance – if extremity is pale, cyanotic or discolored
• = Temperature – cool if arterial problem
• = Capillary refill – less than 3 seconds
• = Hardness – supple (soft) or hard and inelastic
• = Edema – pitting or non pitting – measure circumference
• S = Sensation – ask patient about pain, numbness, tingling
WHAT’S THIS ABOUT?

Answer 29

Arterial assessment: PATCHES

Question 30

WHAT TYPE OF assessment DO THESE SYMPTOMS BELONG TO?
• First symptom is usually edema
• Dark pigmentation
• Dryness and scaling
• Ulcerations – Stasis ulcers

Answer 30

VENOUS ASSESSMENT

Question 31

DOE ____________ STANDS FOR & IS common in patients with cardiovascular conditions

Answer 31

DYSPNEA ON EXERTION

Question 32

In order to promote homeostasis….when the blood pressure _______ , the heart rate_________.

Answer 32

DROPS, INCREASES
THIS IS CALLED COMPENSATORY RESPONSE
BE ABLE TO APPLY THIS CONCEPT

Question 33

What peripheral arterial disease diagnostic test does this describe?

A ratio of the blood pressure at the ankle to the blood pressure in the upper arm (brachium). Compared to the arm, lower blood pressure in the leg is an indication of blocked arteries due to peripheral artery disease (PAD).

Answer 33

ABI- ANKLE BRACHIAL INDEX

Question 34

WHICH ANEMIA IS CHARACTERIZED BY Decrease of bone marrow function – activity of the bone marrow is depressed? AS A RESULT, Pancytopenia- a medical condition of a reduction of red, white blood cells, and platelets.

Answer 34

Aplastic anemia

Question 35

Normal PaCO2

Answer 35

38-42