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Care of Adult/Older patients > Diagnostic Studies > Flashcards

Diagnostic Studies Flashcards

1
Q

Cardiac Markers

A
  • CKMB
  • Troponin
  • Myoglobin
  • C-reactive protein
  • BNP
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2
Q

C-reactive protein released from?

A

Liver

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3
Q

BNP released from?

A

Ventricles

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4
Q

Cardiac marker used to predict risk of future cardiac events in patients with unstable angina or previous MI?

A

C-reactive protein

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5
Q

Cardiac marker of choice to differentiate dyspnea related to respiratory or cardiac disease?

A
  • BNP

- Value > 100 indicates HF

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6
Q

Can detect congenital defects, wall motion, and ejection fraction.

A
  • Echocardiogram (US of heart)

- Trans-thoracic or trans-esophageal

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7
Q
  • Measures pressures within heart chambers and ejection fraction (diagnostic)
  • uses Contrast dye
A
  • Cardiac catheterization

- AKA: Cardiac angiogram

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8
Q

Cardiac catheterization on the left side of the heart allows for evaluation of?

A
  • aorta
  • aortic valve
  • left ventricle
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9
Q

Cardiac catheterization on the right side of the heart allows for evaluation of?

A
  • vena cava
  • right atrium
  • right ventricle
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10
Q

Laboratory/diagnostics prior to Cardiac Catheterization?

A
  • H&H
  • electrolytes
    • esp. K and mg
  • coagulation profile
    • PT & INR
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11
Q

Cardiac Catheterization cautions?

A
  • patient with Iodine Allergy

- renal failure patients

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12
Q

Post Cardiac Catheterization complications?

A
  • 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)
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13
Q

Vascular Complications post Cardiac Catheterization?

A
  • Hematoma 93.3%
  • Pseudoaneurysm 10.7%
  • Retroperitoneal Bleed 4%
  • Arteriovenous Fistula 3.3%
  • Femoral Artery Occlusion 0.7%
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14
Q

Nursing Interventions for post Cardiac Cath hematoma?

A
  • 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
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15
Q
  • 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
A

Pseudoaneurysm

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16
Q

Nursing Interventions for a Pseudoaneurysm?

A
  • Assess VS q 15 min
  • Assess site q 15 min
  • Notify MD
    -expect groin
    ultrasound with
    possible thrombin
    injection
17
Q

Physical Findings of a Retroperitoneal Bleed?

A
  • Moderate to severe back/flank pain
    • may be only
      symptom until
      hypovolemic shock
      occurs
  • 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
18
Q

Nursing Interventions fora Retroperitoneal Bleed?

A
  • 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
19
Q

What is a significant indicator of a Retroperitoneal Bleed?

A

Patient demonstrates a strong urge to move bowels but is unable to do so

20
Q

How much blood can a person collect in their abdomen before S/S of a retroperitoneal bleed appear?

A

1 - 1.5L

21
Q

An abnormal connection formed between the femoral artery and the femoral vein.

A

Arteriovenous Fistula

22
Q

Physical Findings of an Arteriovenous Fistula?

A
  • 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
23
Q

Nursing Interventions for an Arteriovenous Fistula?

A
  • VS q 15 min
  • Assess site and pedal pulses q 15 min
  • Notify MD
    -expect groin
    ultrasound
24
Q

Clot formation in the femoral arterial system.

A

Arterial Occlusion

25
Q

Physical Findings of an Arterial Occlusion?

A
  • Diminished or absent pulse

- Pain, pallor, coolness or paresthesia of leg

26
Q

Nursing Interventions for an Arterial Occlusion?

A
  • VS q 15 min
  • Assess site and pedal pulses q 15 min
  • Notify MD
    -expect LE doppler,
    possible surgical
    intervention or
    thrombolysis
27
Q

Symptoms of Hypovolemia?

A
  • Tachycardia
  • Hypotension
  • Decreased urine output
  • Pale, cool, mottled skin
  • Diaphoretic
28
Q

Results from loss of circulating or intravascular volume

A

Hypovolemic Shock

29
Q

S/S of hypovolemia occur with a MAP value of?

A

< 60 mmHg

30
Q

Normal MAP values?

A

70 - 105 mmHg

31
Q

The average pressure within an artery over a complete cycle of one heartbeat.

A

Mean Arterial Pressure (MAP)

32
Q

ECG reading that indicates myocardial ischemia or injury with partial or total occlusion of a coronary artery?

A

ST elevations

Care of Adult/Older patients (5 decks)

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