Cath protocols and procedures

Question 1

What are flow directed catheters used for?

Answer 1

Right heart cath

Question 2

What accessory should be placed on a swan that is to be left in the patient post catheterization?

Answer 2

Septi-Shield sterile sleeve

Question 3

What needle is used in a modified seldinger technique?

Answer 3

18 gauge cook needle

Question 4

What is the recommended amount of contrast?

Answer 4

3ml/kg

Question 5

Elevation of the feet may assist with vascular access for which of the following approaches?

Answer 5

internal jugular

Question 6

What substance is used in radiographic contrast that makes it radiopaque?

Answer 6

iodine

Question 7

Which catheter is used for a right heart cath?

Answer 7

Swan-Ganz

Question 8

Which drug is commonly used to achieve anti-coagulation during cardiac catheterization?

Answer 8

Heparin

Question 9

Which anti-coagulation medication is better for diabetics and patients who are allergic to protamine?

Answer 9

Angiomax

Question 10

What are the renal panel labs?

Answer 10

BUN

Creatinine

Question 11

Why is a left ventriculogram performed?

Answer 11

measure Ejection Fraction

Question 12

Left Ventriculogram is most likely performed using which catheter?

Answer 12

angled pigtail

Question 13

Name a collagen based vascular closure device.

Answer 13

Angioseal / Mynx

Question 14

Where is the three ring control syringe connected to?

Answer 14

Four port manifold

Question 15

Which catheter is preferred during an angiography of the RCA?

Answer 15

6JR4.5

Question 16

What kind of guide wires are “slippery when wet”?

Answer 16

Hydrophilic

Question 17

If a patient has a history of contrast allergies, what should be done before the procedure?

Answer 17

premedicate with anti-histamines and steroids

Question 18

How should the skin be prepped with each Povidone-iodine sponge prior to heart cath?

Answer 18

Begin at the inside and scrub away from the puncture site in a spiraling manner

Question 19

Which needle would be the smallest and least traumatic to inject local subcutaneous anesthetic beneath the skin before deep infiltration with lidocaine and arterial puncture?

Answer 19

25 gauge

Question 20

Guidewire diameters are usually measure in what?

Answer 20

thousandths of inches

Question 21

Before catheters, needles and sheaths are inserted into the patient they should have what done to them?

Answer 21

Flushed with heparanized flush solution

Question 22

What complication may occur with frequent and prolonged wedging of Swan Ganz catheter?

Answer 22

Pulmonary hemorrhage

Question 23

During a Judkins coronary arteriography procedure, most strokes and TIA’s are caused by plaque embolizing from where?

Answer 23

Aorta

Question 24

Before attempting a brachial or radial artery puncture, the pulses should be strong. The patency of the ulnar artery and Palmar arch can be checked using what test?

Answer 24

Modified Allen’s Test

Question 25

Which closure device uses a suture based vascular closure system?

Answer 25

Perclose

Question 26

After 6-8 hours after a coronary angiograph what are patients instructed to do?

Answer 26

drink 1-2 quarts of fluid

Question 27

Why are large amounts of fluid given to a patient post angiography?

Answer 27

promotes excretion of dye by the kidneys

Question 28

Name 4 complications that could occur with femoral access.

Answer 28

1. Hematoma
2. Distal embolization
3. Vasovagal reaction
4. Infection

Question 29

How would you treat a vasovagal reaction?

Answer 29

1. IV fluid bolus

2. Atropine 0.5 mg IVP

Question 30

What should the ACT be before pulling the sheath?

Answer 30

160 seconds