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MedSurg > T2: Imaging & Devices > Flashcards

T2: Imaging & Devices Flashcards

1
Q

Routinely obtained to determine the size, silhouette, and position of the heart

A

Chest X-Ray

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2
Q

Chest X-rays:
In acutely ill patients, a simple _______ can be obtained at the bedside

A

anteroposterior (AP)

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3
Q

What can be seen on a chest X-Ray (4)

A

-Cardiac enlargement
-Pulmonary congestion
-Cardiac Calcification
-Placement of central venous catheters (CVC), endotracheal tubes, and hemodynamic monitoring devices

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4
Q

most definitive but most invasive test in the diagnosis of heart disease

A

Cardiac catheterization

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5
Q

Uncommon, but serious complications that may follow coronary arteriography: (7)

A

Myocardial infarction (MI)
Stroke
Arterial bleeding
Thromboembolism
Lethal dysrhythmias
Arterial dissection
Death

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6
Q

Indications for cardiac catheterization

A

-confirm suspected heart disorders
-determine the location and extend the disease process
-assess stage/severity of condition
-determine best therapeutic option
-evaluate effects of medical or invasive treatment

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7
Q

Nursing actions pre-cardiac catheterization (7)

A

-Teach pt about procedure
-Obtain consent
-Pre-procedure exams
-Solids and non-clear liquids held 6 hours before procedure
-Clear liquids held 2 hours before procedure
-Prepare surgical site with antiseptic
-Obtain vitals

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8
Q

Cardiac catheterization:
right side Cath through ___(1_____
left side Cath through ___(3)____

A

right side: femoral artery
left side: femoral, brachial, or radial artery

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9
Q

Pre-Heart Cath tests (4)

A

-Chest X-Ray
-CBC
-Coagulation studies
-12 lead ECG

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10
Q

Nursing Actions: Post Heart Cath

A

-HOB at 30 degrees
-Bedrest 2-6 hours with surgical limb remaining straight
-Monitor vital signs
-Assess site for blood drainage or hematoma

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11
Q

Routine part of every cardiovascular evaluation and is one of the most valuable diagnostic tests

A

Electrocardiography

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12
Q

Various forms of ECG: (5)

A

-Resting
-Continuous ambulatory (holter)
-Exercise (stress test)
-Signal-averaged
-30-day event monitoring

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13
Q

Resting ECG provides information about: (6)

A

-Cardiac dysrhythmias
-Myocardial ischemia
-Site and extend of MI
-Cardiac hypertrophy
-Electrolyte imbalances
-Effectiveness of cardiac drugs

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14
Q

assesses cardiovascular response to an increased workload

A

Stress test

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15
Q

Nurse actions: stress test (8)

A

-inform pt
-attach 12 leads
-light meal 2 hours before
-comfortable outfit
-monitor vitals and note baseline BP
-check med history
-prep for resuscitation
-set treadmill to 1-10 mph w/ gradual incline

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16
Q

On cardiac stress test, patient continues to exercise until one of the following occurs: (4)

A

-Predetermined HR is reached and maintained
-Signs and symptoms appear
-Significant ST-segment depression or T-wave inversion occurs
-20 minute protocol is completed

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17
Q

Nursing actions: post stress test

A

-monitor VS
-No hot showers for 1-2 hours after
-telemetry observation

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18
Q

noninvasive, risk free test that uses ultrasound waves to assess cardiac structure and mobility, particularly of the valves

A

echocardiography

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19
Q

Echocardiography is used to help assess and diagnosis: (6)

A

-Cardiomyopathy
-valvular disorders
-pericardial effusion
-left ventricular function
-ventricular aneurysms
-cardiac tumors

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20
Q

nursing action: echocardiography

A

-no special prep
-pt lies down on left side with HOB elevated 15-20 degrees
-takes 30-60 minutes to complete

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21
Q

test used when patients cannot tolerate exercise; slightly more aggressive form due to the use of pharmacological induction of stress

A

pharmacologic stress echocardiogram

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22
Q

Pharmacologic stress echocardiograms use what medications that do what (2)

A

-Dobutamine increases the heart’s contractibility
-Dipyridamole is a coronary artery dilator

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23
Q

Nursing actions: pharmacologic stress echocardiogram

A

-NPO 3-6 hours before
-IV access is present before procedure
-Monitor BP and pulse continuously throughout procedure

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24
Q

Nursing actions: post pharmacologic stress ECG

A

vital signs monitored until BP returns to baseline and pulse rate slows to less than 100 bpm

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25
Q

examining cardiac structure and function with an ultrasound transducer placed immediately behind the heart in the esophagus or stomach

A

Transesophageal ECG

26
Q

Transducer used in trasnesophagela ECG provides detailed views of ______ cardiac structures such as:

A

-posterior
-left atrium, mitral valve, and aortic arch

27
Q

generates & transmits electrical impulses which stimulates contractions of the atria and then the ventricels

A

cardiac conduction system

28
Q

Steps in the heart’s conduction system:
(Send a big bounding pulse)

A

-SA node
-AV node
-Bundle of HIs
-Bundle branches
-Purkinje Fibers

29
Q

Primary pacemaker of the heart; creates electrical impulses of 60-100 bpm

A

SinoAtrial (SA) node

30
Q

Secondary pacemaker of the heart “backup pacemaker”; SA node malfunctions, the AV node takes over at a rate of 40-60 bpm

A

AtrioVentricular (AV) node

31
Q

If the SA and AV nodes fail, the Purkinje fibers can fire at a rate of ________-

A

30-40 bpm

32
Q

ECG: atrial contraction (depolarization)

A

P wave

33
Q

movement of electrical activity from atria to ventricles

A

PR segment

34
Q

Ventricle contraction (depolarization)

A

QRS complex

35
Q

Time between ventricular depolarization & repolarization

A

ST segment

36
Q

Ventricle relaxing (depolarization)

A

T wave

37
Q

Ventricles relaxing and filling

A

TP interbal

38
Q

ECG: 60-100 bpm

A

normal sinus

39
Q

ECG: >100 bpm

A

sinus tachycardia

40
Q

ECG: < 60 bpm

A

Sinus Bradycardia

41
Q

Electronic apparatus used to initiate heartbeat when the SA node is seriously damaged and unable to act correctly

A

pacemaker

42
Q

Types of pacemakers (4)

A

-Internal/implantable
-External
-Temporary
-Permanent

43
Q

Major methods of cardiac pacing (2)

A

Rate responsiveness pacemaker
Demand pacemaker

44
Q

pacemaker allows faster pacing rates to meet increased bodily demand

A

rate responsiveness pacemaker

45
Q

electrode wire inserted percutaneously and threaded though to the ventricle; battery pack is implanted under skin

A

Demand pacemaker

46
Q

Technical problems associated with cardiac pacing (5)

A

-Dislodgment and migration of endocardial leads
-Wire breakage
-Cracking of insulation surrounding wires
-Infection of sites surrounding either pacing wires or pulse generator
-Battery exhaustion

47
Q

Pacemaker batteries can last ______. A computer monitors ____________ of the pacemaker. It could be a ___, _____, or ____chamber pacemaker

A

-5-10 years
-electrical activity and tailor function
-single, double, or triple chamber

48
Q

Pacemaker functions when heart rate goes below set rate

A

Demand pacemaker

49
Q

Pacemaker that stimulates ventricles at preset constant rate

A

fixed rate pacemaker

50
Q

pacemaker used in emergency situations

A

Temporary pacemaker

51
Q

Pacemaker is placed within right ventricle or right atrium and ventricle, and generator is implanted under skin below clavicle or in abdominal wall

A

permanent pacemaker

52
Q

synchronized countercheck that may be performed to restore normal conduction in a hospitalized patient with -onset AF; can also be ordered for stable AF that is resistant to medical therapy

A

Cardioversion

53
Q

Synchronized cardioversion is used to treat both:

A

-hemodynamically unstable ventricular
-supraventricular rhythms

54
Q

nursing care before cardioversion includes: (8)

A

-informed consent
-Diazepam or Midazolam IV
-Voltage 25-360 watts/s
-digoxin withhold 48 hours prior to procedure
-synchronizer turned on, check at the R wave
-Oxygen discontinued
-Assess airway latency
-assess vital signs every 15 mins for first hour, then every 30 mins for 2 hours

55
Q

Nursing care after cardioversion includes: (8)

A

-maintaining a patent airway
-administer oxygen
-assessing vital sings and the level of consciousness
-administering antidysrhythmic drug therapy
-monitoring for dysrhythmias
-assessing for chest burns from electrodes
-Providing emotional support
-documenting the results of cardioversion

56
Q

used in the treatment of v-fib; device sends an electrical pulse to the heart to restore a normal heartbeat (preventing/correcting uneven heartbeats

A

defibrillation

57
Q

Defibrillation completely __________ the myocardial cells so SA node can be pacemaker

A

depolarizes

58
Q

indicated for patients who have experienced one or more episodes of spontaneous sustained ventricular tachycardia (VT), or ventricular fibrillation (VF) not caused by a myocardial infarction (MI)

A

Implantable cardioverter defibrillator

59
Q

continuously monitor the heart and apply a defibrillator shock to bring the pt back to NSR if it identifies that the pt has a shockable dysrhythmia

A

Implantable cardioverter defibrillator

60
Q

ICDs are indicated for patients who have experienced one or more episodes of ____ or _____ not caused by myocardial infarction (MI)

A

-ventricular tachycardia
-ventricular fibrillation

MedSurg (14 decks)

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