Cardiovascular Assessment

Question 1

What happens to the left ventricle with aging?

Answer 1

— increases size
— becomes stiff
— less diste si le
— decreases speed of diastolic filling by 50%
— decrease in stroke volume, ejection fraction, and cardiac output
— less able to meet oxygen demands

*LV pumps against greater resistance
LV hypertrophy

Question 2

What happens with the aorta with aging?

Answer 2

— thick, stiff, and less diste si le
— systolic BP increases
— systemic vascular resistance increases
— MONITOR FOR HTN

Question 3

Current health concerns/symptoms to assess:

Answer 3

— chest pain
— dyspnea
— fatigue
— palpitations
— edema
— syncope
— extremity pain

Question 4

Which laboratory assessment evaluates myocardial muscle protein when there is injury to myocardial muscle?

Answer 4

Troponin

Question 5

What is creatinine kinase?

Answer 5

Enzyme specific to cells of the brain, myocardium, and skeletal muscle
CK indicates tissue necrosis or injury
Range: 30-170

Question 6

What is the protein found in cardiac and skeletal muscle?

Answer 6

Myoglobin
<90

Question 7

What is the normal range for total cholesterol?

Answer 7

<200

Question 8

What is the normal range for triglycerides?

Answer 8

Below 150

Question 9

What are normal ranges for HDL + LDL?

Answer 9

HDL= >45
LDL= <130

Question 10

BNP (B-type natriuretic peptide)

Answer 10

Dx of HF
>100
BNP is produced and released by ventricles when they are stretched and fluid overload

Question 11

What is homocysteine?

Answer 11

Amino acid produced when proteins break down
Elevated levels indicates increase risk for cardiac disease
<14

Question 12

What is C-reactive protein?

Answer 12

Any inflammatory process can produce CRP in blood
<1.0
>3 indicates increase risk for heart disease
Elevations seen with HTN, infection, and smoking

Question 13

What is microalbuminuria?

Answer 13

Small amounts of protein in urine
Incidentes endothelial dysfunction

Question 14

What are CM of hypokalemia and hyperkalemia in heart failure patients?
What is normal range for potassium?

Answer 14

Hypokalemia:
— increased electrical instability
— ventricular dysrhythmias
— digitalis toxicity
Hyperkalemia:
— slowed ventricular conduction
— peaked T waved on ECG
— contraction followed by ASYSTOLE

3.5-5.0

Question 15

What are CM with hypocalcemia + hypercalcemia? What is normal range of calcium?

Answer 15

Hypocalcemia:
— ventricular dysrhythmias
— prolonged QT interval
— CARDIAC ARREST
Hypercalcemia:
— short QT interval caused AV block
— digitalis hypersentitivity
— CARDIAC ARREST

8.4-10.5

Question 16

What happens with hypomagnesemia?

Answer 16

Prolongs QT interval causing Vtach

1.5-2.5

Question 17

What diagnostic testing examines size, silhouette, and position of the heart?

Answer 17

CXR

Question 18

Which diagnostic testing uses contrast dye to examine arterial vessels?

Answer 18

Angiography/arteriography
— sedation required
— NPO status
— screen for allergies

Question 19

What is an echocardiography?

Answer 19

Ultrasound to assess cardiac structures and mobility
Specifically looks at valves
No prep required

Question 20

Which diagnostic testing examines cardiac structure and function using ultrasound that is placed behind the heart in the esophagus or stomach?

Answer 20

Transesophageal echocardiography
— sedation required

Question 21

What do you need to screen for before an MRI?

Answer 21

Metallic objects

Question 22

How do you prep your patient for a cardiac catheterization?

Answer 22

— fluids may be given 12-24 hr before procedure for renal protection
— CXR, CBC, coagulation screen, ECG done
— NPO after MN or liquid breakfast
— assess for contrast dye allergy
— sedative
— hold diuretics prior to procedure

Question 23

What is post procedure care for cardiac cath?

Answer 23

— bed rest and keep insertion site extremity straight
— VS
— assess insertion site for drainage or hematoma
— assess peripheral pulses, temp, and color of skin
— monitor I&O / maintain hydration
— observe for complications