Diagnostic Studies Flashcards
Cardiac Markers
- CKMB
- Troponin
- Myoglobin
- C-reactive protein
- BNP
C-reactive protein released from?
Liver
BNP released from?
Ventricles
Cardiac marker used to predict risk of future cardiac events in patients with unstable angina or previous MI?
C-reactive protein
Cardiac marker of choice to differentiate dyspnea related to respiratory or cardiac disease?
- BNP
- Value > 100 indicates HF
Can detect congenital defects, wall motion, and ejection fraction.
- Echocardiogram (US of heart)
- Trans-thoracic or trans-esophageal
- Measures pressures within heart chambers and ejection fraction (diagnostic)
- uses Contrast dye
- Cardiac catheterization
- AKA: Cardiac angiogram
Cardiac catheterization on the left side of the heart allows for evaluation of?
- aorta
- aortic valve
- left ventricle
Cardiac catheterization on the right side of the heart allows for evaluation of?
- vena cava
- right atrium
- right ventricle
Laboratory/diagnostics prior to Cardiac Catheterization?
- H&H
- electrolytes
- esp. K and mg
- coagulation profile
- PT & INR
Cardiac Catheterization cautions?
- patient with Iodine Allergy
- renal failure patients
Post Cardiac Catheterization complications?
- Abrupt closure and vascular injury
- Acute MI/CVA
- Stent embolization
- Coronary spasm
- Emergent coronary artery bypass graft (CABG) if tear or clog in artery
- Dysrhythmias (during and after)
Vascular Complications post Cardiac Catheterization?
- Hematoma 93.3%
- Pseudoaneurysm 10.7%
- Retroperitoneal Bleed 4%
- Arteriovenous Fistula 3.3%
- Femoral Artery Occlusion 0.7%
Nursing Interventions for post Cardiac Cath hematoma?
- Apply pressure (up to 20 min)
- Assess VS q 15 min
- Assess site q 15 min until hematoma is no longer enlarging
- Measure & outline width and length of outer ridge
- Document hematoma size in cm
- Notify MD of any and all hematoma (pre or post sheath removal)
- Notify MD if femostop applied for any reason
- Localized dissection or tear in the inner wall of the artery with formation of an extravascular hematoma that enlarges the vessel
- may cause new bruit
Pseudoaneurysm
Nursing Interventions for a Pseudoaneurysm?
- Assess VS q 15 min
- Assess site q 15 min
- Notify MD
-expect groin
ultrasound with
possible thrombin
injection
Physical Findings of a Retroperitoneal Bleed?
- Moderate to severe back/flank pain
- may be only
symptom until
hypovolemic shock
occurs
- may be only
- Pain is unrelieved by analgesics
- Unexplained hypotension
- Recurrent hypotension after fluid replacement
- Urge to move bowels
- Difficult to detect by abdominal examination alone, especially if obese
Nursing Interventions fora Retroperitoneal Bleed?
- Assess VS q 15 min
- Assess site and pedal pulses q 15 min
- Assess neuro status
- Notify MD
-expect CT to r/o
retroperitoneal
bleed - Possible surgical intervention to control bleeding
- Monitor H/H
What is a significant indicator of a Retroperitoneal Bleed?
Patient demonstrates a strong urge to move bowels but is unable to do so
How much blood can a person collect in their abdomen before S/S of a retroperitoneal bleed appear?
1 - 1.5L
An abnormal connection formed between the femoral artery and the femoral vein.
Arteriovenous Fistula
Physical Findings of an Arteriovenous Fistula?
- Swelling at site
- Pain in leg
- New bruit at site
- May have signs of high output heart failure because of shunting of blood into venous system
Nursing Interventions for an Arteriovenous Fistula?
- VS q 15 min
- Assess site and pedal pulses q 15 min
- Notify MD
-expect groin
ultrasound
Clot formation in the femoral arterial system.
Arterial Occlusion
