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3.1 - ABSN NUR 405 CV I Content > CV Labs & Diagnostics > Flashcards

CV Labs & Diagnostics Flashcards

1
Q

what is Troponin an indicator of?

A

most sensitive indicator of myocardial damage

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2
Q

what does troponin differentiate between?

A

cardiac vs non cardiac chest pain

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3
Q

how long after an MI does a troponin elevate?

A

2-3 hours

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4
Q

when does a troponin level return to baseline?

A

10-14 days

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5
Q

what is the lab draw schedule for troponin?

A

initial occurrence, 12 hours, then daily for 3-5 days

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6
Q

What is a CK-MB?

A

an enzyme found primarily in the heart muscle, helps to diagnose an acute MI

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7
Q

how long is a CK-MD elevated after an MI?

A

3 hours

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8
Q

when does a CK-MD peak?

A

24 hours after MI

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9
Q

between a troponin and a CK-MB which is more specific to cardiac damage?

A

troponin

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10
Q

What does C-reactive protein (CRP) indicate?

A

inflammatory illness

NONSPECIFIC

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11
Q

when does a CRP peak?

A

18-72 hours

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12
Q

if a CRP fails to normalize what may it indicate?

A

ongoing damage to heart muscle

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13
Q

how is a CRP useful?

A

monitors acute inflammation

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14
Q

when is a CRP not elevated?

A

with angina

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15
Q

What is a Erythrocyte Sedimentation Rate (ESR) used for?

A

nonspecific indicator of acute OR chronic infection, inflammation, or tissue infarction

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16
Q

how is an ESR useful?

A

monitors for chronic inflammation

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17
Q

What is a BNP the main source in?

A

cardiac ventricle

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18
Q

what does BNP aid in?

A

distinguishing between cardiac vs. respiratory causes of dyspnea

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19
Q

when are concentrations higher in a Pro-BNP?

A

Left ventricular dysfunction

levels are approximately fourfold higher than BNP concentrations

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20
Q

what is the main lipid associated with CV disease?

A

cholesterol

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21
Q

what are the two sources of cholesterol?

A

endogenous and exogenous

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22
Q

what affects cholesterol?

A

malnutrition

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23
Q

what are two types of lipoprotiens?

A

HDL,LDL

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24
Q

are lipoproteins an accurate predictor of heart disease?

A

yes

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25
what is HDL's job?
to remove cholesterol | HDL is good cholesterol
26
What is LDL's job?
to deposit cholesterol in peripheral tissues | LDL "low down dirty" bad cholesterol
27
what is a normal cholesterol range?
150-200 <200 low risk of CAD 200-240 mod risk of CAD >240 high risk of CAD
28
what is a normal range of triglycerides?
40-160 | >190 high risk of CAD
29
What is a normal range of LDL?
<100 130-159 mod risk for CAD >160 high risk of CAD
30
What is a normal range of HDL?
>40-50 >60 low risk of CAD <40 high risk of CAD
31
types of non-invasive procedures for CV disease
EGK/ECG Holter monitor Exercise stress test Echocardiogram
32
what is the difference between a 12 lead EKG and telemetry?
EKG provides a more accurate picture of electroconductivity of the heart
33
What is a holter monitor
ambulatory EKG/ECG monitoring
34
what do you teach a patient prior to a holter monitor
test is painless requires no prep electrodes must stay firm against chest. continue with usual activities
35
how long do patients wear a holter monitor?
24 hours
36
what is a holter monitor used for?
to dx atrial fib
37
what are some reasons a patient may wear a holter monitor?
syncope or tachycardia
38
what is an exercise stress/treadmill test used for?
to evaluate the hearts response to exercise can use a treadmill or exercise bike exercise may unmask symptoms of CAD or dysrhythmias in patients with minimal symptoms with normal activity
39
what must be continuously monitored during a exercise stress test?
heart monitoring and vital signs
40
is there special prep for an exercise stress test?
no, wear comfortable shoes and clothes
41
what are echocardiograms used for?
uses sound waves to create moving pictures of the heart to evaluate valves and chambers of the heart.
42
what does an echocardiogram measure?
ejection fraction
43
what do you teach a patient about an echocardiogram?
no prep no radiation is used painless can be done at bedside
44
what is ejection fraction?
Percentage of blood pumped out of the left ventricle with each contraction.
45
what is a ejection fraction an indicator of?
effectiveness of the heart to pump
46
what is a normal ejection fraction?
55-70% | values less than 40% are seen with HF
47
types of invasive procedures of CV disease
trans-esophageal echocardiogram (TEE) cardiac catheterization Electrophysiology study (EPS)
48
What department is a TEE done in?
vascular lab
49
how is a TEE done?
a probe with an ultrasound inducer is placed down the throat with the end near the heart. Provides improved images, compared to an echo contrast dye may be used
50
what type of sedation is used with a TEE?
requires IV access | can be local or conscious sedation
51
how long must a patient be NPO for a TEE?
6 hours
52
what must be removed from the patient prior to a TEE?
dentures
53
What must return before a patient can take anything by mouth after a TEE?
gag reflex
54
what symptom can be expected after a TEE?
sore throat
55
What does an EPS do?
evaluates the electrical health of the heart induces dysrhythmia's confirms the root of the suspected electrical problem of the heart
56
what must be stopped several days before an EPS?
anti-dysrhythmics
57
how long must a patient be NPO before a EPS?
8 hours
58
What type of sedation is used for an EPS?
IV sedation
59
where are the catheters placed during a EPS?
near SA, AV nodes, and right ventricle
60
what must be checked frequently after a EPS?
VS
61
what is diagnostic use of cardiac catheterization with angiography "heart cath" used for?
to confirm location and extent of CAD
62
what is the therapeutic use of a heart cath?
to perform an intervention such as angioplasty/stent placement
63
what type of information does a heart cath provide?
about heart muscles, blood vessels and valves.
64
what path does a LT heart cath follow?
``` aorta RT coronary artery LT anterior descending coronary artery Circumflex coronary artery LT main coronary artery ```
65
what are the insertion sites of a heart cath?
neck or groin ( RT or LT femoral, radial, brachial artery)
66
angiogram
done during a heart cath contrast dye injected through catheter and xray images are taken. pt may feel a warm flush
67
nursing pre-procedure responsibilities of a heart cath
``` NPO (some may be allowed morning meds with small sip of water) consent signed pt/family teaching little pain will experience hot flash when dye injected check labs BUN/Cr empty bladder local anesthesia and IV sedation likely ```
68
nursing post-procedure responsibilities of a heart cath
will occur in cath lab or observation area heparin drip will be d/c and clotting time monitored before sheath is pulled when sheath removed apply pressure bed rest frequent circulation checks of extremities check for pulses, color and sensation
69
what must be checked before the sheath can be removed following a heart cath?
clotting times
70
how long must you apply pressure after removing the sheath from a heart cath?
20 min
71
how long must a patient remain in bed after a heart cath and what position?
at least 6 hours with affected leg straight and HOB BELOW 30 degrees
72
potential complications of a heart cath?
bleeding (heparin drip used during procedure, monitor puncture site closely for hematoma) emboli ( monitor for s/s of stroke) infection dysrhythmias damage to heart (cardiac tamponade) allergic reaction to dye renal failure (r/t contrast dye "nephrotoxic")
73
what is contrast nephrotoxicity?
AKI occurring within 3 days of contrast dye injection | major cause of AKI in hospitalized patients
74
what patient populations are at higher risk of contrast nephrotoxicity?
pre-existing renal impairment, diabetic, FVD patients
75
how do you prevent contrast nephrotoxicity?
sodium bicarb IV and acetylcysteine PO before and after procedure force fluids

3.1 - ABSN NUR 405 CV I Content (8 decks)

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