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Nursing 202 Cardiac Test

Terms in this set (52)

Coronary Arteries
Right coronary artery (feeds the inf. L ventricle & R side of heart), LAD ( left anterior descending) coronary artery, and the circumflex artery. The LAD and circumflex branch off from the left coronary artery
Atherosclerosis
plaque build up in arteries
Myocardial Infarction
the occlusion of one or more coronary arteries caused by plaque buildup (heart attack)
Exercise stress test
study that evaluates cardiac function during physical stress by riding a bike or walking on a treadmill. 12 lead EKG is used to watch for ST segment depression/T wave inversion.
ST segment depression or T wave inversion indicates:
ischemia
Ischemia is
Lack of blood flow to tissue
Thallium Stress test
stress test using a radioactive tracer to see how it has been taken up in the patients myocardium and if there are any blockages.
Nursing considerations for stress tests
NPO for 6 hours. No smoking, no caffeine. No medicine or anything that will raise or decrease their HR. No nitrates, no beta blockers
Trans-cutaneous Echocardiogram
Using a probe on the outside of the chest, we can see the valves, chambers, and structure of the heart
Measurement we get from an echocardiogram
Ejection Fraction
Ejection Fraction represents
the functioning of the Left ventricle
TEE
transesophageal echocardiogram (invasive)
TEE is done immediately prior to a:
cardioversion
Nursing considerations for TEE
sprayed the back of the throat so probe can go down. Must check for gag reflex afterwards. Consent form signed. IV conscious sedation used.
Troponin
Gold standard lab test for ruling out MI
Troponin levels increase proportionately with:
how much damage has been done to the myocardium
If ST segment elevation is high, then:
troponin levels will be high
CPK-MB
creatine phosphokinase-MB, done to see if someone had a MI. Levels rise quicker than troponin
Myoglobin
An oxygen-storing, pigmented protein in muscle cells. Test done to see if someone may have had an MI. This rises quicker than Troponin does
Troponin is done in a ( _______) fashion.
serial fashion to test if your numbers eventually rise, meaning you had an MI
Lipid panel
series of blood tests (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides) used to assess risk factors of ischemic heart disease
HDL
high density lipoproteins (healthy type of cholesterol) we want HIGH to be HIGH
LDL
low density lipoprotein (bad cholesterol) LOWs should be LOW
BNP helps us diagnose :
Heart failure
Normal BNP
0-100
The higher the BNP number, the more severe the :
heart failure
cardiac cath
cardiac catheterization; thread catheter into the aorta and inject dye. Allows us to visualize coronary arteries. (Angiogram part of the cardiac cath)
Angiogram
The radiographic visualization of blood vessels after the injection of radiopaque substance.
PCI (percutaneous coronary intervention)
Done during cardiac cath. It is angioplasty. We can either use a metal stent to open up an artery or inflate a balloon to push the plaque up against the vessel walls.
Nursing considerations for cardiac cath:
consent. Allergies to iodine/shellfish. Assess for bleeding post op, distal pulses, (femoral, radial, calf). Always monitor for emboli!
Blue toe syndrome
Intermittent painful blue toes (or fingers) due to microemboli from a proximal arterial plaque. TURNS TOES BLUE!
PTT (partial thromboplastin time)
normal = 20-35 seconds; on heparin therapy goal is 1.5 - 2.5 times this
PT (prothrombin time)
11-12.5 seconds
INR
0.8-1.1
Signs of right sided heart failure
edema, JVD, peripheral edema, ascites, hepatomegaly, anasarca
Signs of left sided heart failure (LEFT IS LUNG)
Decreasing BP
Anxious, pale, tachycardic
Crackles, wheezes, dyspnea, and cough
Pulmonary edema, rales, paroxysmal nocturnal dyspnea
Normal Dig level
0.5-2
Dig toxicity s/s
*yellow/green halos
n/v/d
lethargy
bradycardia*
Beta blockers (for CHF)
decrease the amount of oxygen the heart needs by slowing it down/making it more efficient
ACE inhibitors (for CHF)
decrease preload, decrease after load. Takes the load off of the heart, allowing it to pump more efficiently
Diuretics (for CHF)
unloads the fluid
Tests for CAD
stress test. If patient fails that, then cardiac cath
Modifiable risk factors for CAD
Smoking, HTN, DM, obesity, diet, activity level, hyperlipidemia
Non modifiable risk factors for CAD
Age
Gender
Ethnicity
Family history
Genetic predisposition
acute coronary syndrome (ACS)
sudden symptoms of insufficient blood supply to the heart indicating unstable angina or acute MI
Unstable angina
chest pain at rest or chest pain of increasing frequency
Non-STEMI
non-ST elevation myocardial infarction
STEMI
ST elevation MI, real-time ongoing death of heart tissue due to ischemia
chest pain, positive troponin, and ST segment depression or T wave inversion means the patient had a :
Non STEMI
If patient has positive troponin and elevated ST segment they had a :
STEMI (ST segment elevation MI)
MONA
morphine, oxygen, nitrates, aspirin (for MI or ACS)
chest pain is the heart screaming for oxygen. What do we do first?
Re perfuse the patient!
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