Mod 1 - Safety, Compliance, & Coordinated Pt Care

Question 1

define HOLTER MONITOR

Answer 1

portable batter-operated device that continuously monitors heart activity for at least 24 hrs

Question 2

aka: holter monitor

Answer 2

ambulatory monitor

Question 3

define EVENT RECORDER

Answer 3

form of outpatient cardiac testing involving pt triggering machine to record when experiencing cardiac symptoms

Question 4

define SAFETY DATA SHEET (SDS)

Answer 4

documentation provided by manufacturers of potentially harmful substances that list chemical components, associated hazards, & treatment in case of exposure

Question 5

what is considered elevated BP

Answer 5

120-129/<80

Question 6

what is considered stage 1 hypertension

Answer 6

130-139/80-89

Question 7

what is considered stage 2 hypertension

Answer 7

> 140/>90

Question 8

what is considered hypertensive crisis

Answer 8

> 180/>120

Question 9

what is healthy BP

Answer 9

< 120/<80

Question 10

when is the brachial pulse most often used

Answer 10

when finding pulse on children

Question 11

what are factors of pulse

Answer 11

rate, rhythm, volume

Question 12

define a thready pulse

Answer 12

faint/difficult to detect

Question 13

define a bounding pulse

Answer 13

very strong

Question 14

what can affect pulse rate

Answer 14

age, activity level, fitness level, emotions, position, size, medications, environment temp, illness

Question 15

what is the avg heart rate for newborns (birth-1month)

Answer 15

120-160

Question 16

what is the avg heart rate for infants (1-12months)

Answer 16

80-140

Question 17

what is the avg heart rate for toddlers (1-3 years)

Answer 17

80-130

Question 18

what is the avg heart rate for preschoolers (3-5 yrs)

Answer 18

80-120

Question 19

what is the avg heart rate for elementary kids (6-15 yrs)

Answer 19

70-100

Question 20

what is the avg heart rate for adults (>15 yrs)

Answer 20

60-100

Question 21

respiratory rate ___ with age

Answer 21

decreases

Question 22

what is respiratory rate for newborn

Answer 22

30-50 min

Question 23

what is the range for tachypnea?

Answer 23

> 20 min

Question 24

what is the range for bradypnea

Answer 24

<10/min

Question 25

why might respiratory ranges be abnormal?

Answer 25

acid-base imbalance, hypoxia, brain injury, organ failure, respiratory distress, illness, medication

Question 26

what is normal range for pulse ox?

Answer 26

95-100

Question 27

what might cause errors for a pulse ox?

Answer 27

cold hands, nail polish/fake nails, edema, carbon monoxide poisoning

Question 28

list signs of adequate oxygen perfusion

Answer 28

- warm skin - pink mucous membranes - strong peripheral pulse - capillary refill less than 2 seconds

Question 29

low O2 rates can cause what in regards of testing

Answer 29

abnormalities

Question 30

for pt's with chronic lung conditions & poor O2 saturation they cannot be in a full supine position can be put in this position for an EKG

Answer 30

semi-Fowler's or other upright position

Question 31

how should the pt undress for EKG

Answer 31

undress waist up w/lower legs or ankles accessible, remove panty hose/tights, drape over front

Question 32

what should be removed from pt for EKG

Answer 32

electronic devices, conflicting jewlery

Question 33

What should you instruct the pt when preparing for EKG

Answer 33

- remove electronics - lie flat supine w/head sightly elevated - do not touch anything that conducts electricity - remain as still as possible & avoid talking & moving for 10 sec while machine records - tell pt to tell tech of itching/swelling/redness where electrodes were

Question 34

the stress test is designed to provoke what in a controlled manner

Answer 34

myocardial ischemia

Question 35

what are potential complications of a stress test

Answer 35

hypotension, arrhythmias, myocardial infarction

Question 36

List preprocedure instructions for a stress test

Answer 36

- avoid caffeine/decaf, tobacco, & alcohol at least 3 hours before - eat light meal 2 hours prior test/word of provider - take meds as usual unless told otherwise - pt w/diabetes mellitus consult primary for insulin dosage - wear comfortable, loose-fitting clothing & sturdy nonskid walking shoes - plan to be in office 2-3 hrs depending on test & provider consultation

Question 37

what should the CET tell the PT while performing stress test

Answer 37

- skin will be cleaned & hair might be removed for electrodes on chest & BP cuff - notify tech of itching/swelling/redness where electrodes touch skin - baseline EKG taken @ rest - inform tech of any allergies/inhaler history - test will stop if fatigue/lightheadedness/ dizziness/short of breath/chest pain

Question 38

what should the CET tell the PT after the stress test

Answer 38

sit/stand still for few minutes while machine continues to record - resume normal activities as tolerated

Question 39

what should the CET tell the PT before using a Holter Monitor

Answer 39

- bathe before appt & avoid while being tested - wear loose fitting clothes & w/o a bra - don't remove electrodes/leads - notify tech if itching/swelling/redness where electrodes were - continue normal schedule - keep journal for test - call 911 if serious s/s - return monitor

Question 40

list s/s of cardiopulmonary distress

Answer 40

- tachycardia/bradycardia - pallor - diaphoresis (excessive sweating) - low BP - fast/labored/shallow/slow respirations - anxiety/confusion - cyanosis - chest pain radiating back/arms/jaw - chest tightness - short of breath