Nursing the Cardiac Patient

Question 1

What needs to be assessed upon clinical examination? (8 points)

Answer 1

• Pulse rate, rhythm and quality.
• Compare pulse and heart rate.
• MM colour and CRT.
• Heart and chest auscultation.
• Resting respiratory rate.
• Pulse Oximetry
• Blood pressure measurement
• Abdominal fluid wave

Question 2

What diagnostic tests can be carried out on a cardiac patient?

Answer 2

Radiography
ECG
Echocardiography
Blood Pressure

Question 3

What is an ECG?

Answer 3

Electrocardiography is a measurement of electrical impulses in the heart.

Question 4

What equipment is needed for an ECG?

Answer 4

ECG machine and leads.
Surgical spirit.
Electrode gel.
Swabs.

Question 5

What environment should an ECG be performed in?

Answer 5

Quiet, stress free environment.

Question 6

What is the patient preparation for an ECG?

Answer 6

Clips and legs swabbed with spirit.
Check good lead contact, leads are not touching, no other electrical equipment on.
Patient is not stressed or panting

Question 7

What position should the patient be placed in for an ECG?

Answer 7

Right lateral recumbency with gentle restraint.
Standing can also be used.

Question 8

Where do the ECG leads attach on the patient?

Answer 8

Red – right foreleg
Yellow – left foreleg
Green – left hindleg
Black – right hindleg

Question 9

What is a normal ECG sinus pattern?

Answer 9

Contains a p wave, a QRS Complex and a T wave.
There should be a P for every QRS.
There should be a T for every QRS.
They should have a regular pattern.

Question 10

How is blood pressure monitored?

Answer 10

Cardiac output (CO) x Total peripheral resistance (TRP)

Question 11

What are the normal average blood pressure values for dogs and cats?

Answer 11

Dog – 133mmHg systolic

Cat – 124 mmHg systolic

Question 12

What is a direct way of measuring blood pressure?

Answer 12

Invasive technique using arterial catheter.

Question 13

What is an indirect way of measuring blood pressure?

Answer 13

Non-invasive using external cuff.

Making sure the cuff is placed correctly around the limb, tail or over artery with the cuff covering 40% of the circumference of the limb that’s used.

Question 14

What is the correct procedure for checking blood pressure?

Answer 14

• Stress-free environment.
• Correct cuff width chosen – 40% of leg/tail circumference.
• Place cuff in correct location and keep level with heart.
• Apply spirit and small amount gel to fur over pulse site.
• Apply gel to doppler transducer and inflate cuff slowly until pulse disappears.
• Inflate another 20mm/Hg over then slowly release pressure in cuff
• Reading is taken when pulse returns is systolic pressure
• Take three readings and take average

Question 15

What are the nursing intervention for a cardiac patient?

Answer 15

• Stress free environment
• Minimal handling to reduce stress
• Avoid restraint of chest/neck
• Controlled exercise
• Oxygenation and lung care
• Ensure intravenous access
• Frequent opportunity for urination, monitor fluid intake and weight
• Restricted sodium and palatable diet
• Maintenance of body temperature
• Support sleep/rest
• Accurate medication