ATI Med-Surg Cardiovascular Exam Questions and
Answers
Troponin T
<0.2 ng/mL
elevation detectable after MI 3-5 hrs
Troponin I
<0.03 ng/mL
elevation detectable after MI 3 hrs
Myoglobin
<90 mcg/L
elevation detectable after MI 2 hrs
Echocardiogram
ultrasound of the heart
indications:
cardiomyopathy
heart failure
angina
MI
lay on LEFT side during procedure, takes 1 hr
Stress Testing
measures workload of the heart and how it tolerates "stress"
indications:
angina
heart failure
MI
dysrhythmias
MAY use drugs (adenosine, dobutamine)
FAST 2-4 hrs before
ECG nursing test
Hemodynamic Monitoring
the use of pressure monitoring devices to directly measure cardiovascular function
indications:
serious/critical illness
heart failure
post coronary artery bypass graft patients
ARDS
acute kidney injury
burn injury
trauma injury
lay SUPINE or TRENDELENBURG
place at phlebostatic axis (4th intercostal space, midaxillary line)
Hemodynamic Monitoring Findings
central venous pressure = 1-8
pulmonary artery systolic = 15-25
, pulmonary artery diastolic = 5-15
pulmonary artery wedge pressure = 4-12
mixed venous oxygen saturation = 60-80%
Hemodynamic Monitoring Complications
infection/sepsis -
surgical asepsis when changing dressing (mask, sterile globes, maintain sterile fiedl)
embolism
0.9% sodium chloride for flushing (NO heparin)
Angiography
a radiographic study of the blood vessels after the injection of a contrast medium
indications:
unstable angina
ECG changes
NPO for at least 8 hrs
watch for iodine/shellfish ALLERGY
assess RENAL function
AFTER: maintain bed rest, keep extremity STRAIGHT
Angiography Teaching
no strenous exercise
report bleeding
restrict lifting (<10 lb)
anticoagulation therapy (those who have stent placement)
Angiography Complications
cardiac tamponade
hematoma formation
restenosis of treated vessel
retroperitoneal bleeding
Vascular Access
central catheters:
- nontunneled percutaneous central catheter -
(chemotherapy, blood, antibiotics, TPN)
LONG TERM
- peripherally inserted central catheter -
use up to 12 months
(blood, chemotherapy, antibiotics, TPN)
assess site q 8 hrs
change tube and positive pressure cap at least q 3 days
10 mL or larger syringe to flush
flush with 10 mL of 0.9% sodium chloride
transparent dressing
do NOT immerse in water
NO blood pressure on PICC arm
- tunneled percutaneous central catheter -
long term use
NO dressing needed
- implanted port -
long term (> 1 yr)
Answers
Troponin T
<0.2 ng/mL
elevation detectable after MI 3-5 hrs
Troponin I
<0.03 ng/mL
elevation detectable after MI 3 hrs
Myoglobin
<90 mcg/L
elevation detectable after MI 2 hrs
Echocardiogram
ultrasound of the heart
indications:
cardiomyopathy
heart failure
angina
MI
lay on LEFT side during procedure, takes 1 hr
Stress Testing
measures workload of the heart and how it tolerates "stress"
indications:
angina
heart failure
MI
dysrhythmias
MAY use drugs (adenosine, dobutamine)
FAST 2-4 hrs before
ECG nursing test
Hemodynamic Monitoring
the use of pressure monitoring devices to directly measure cardiovascular function
indications:
serious/critical illness
heart failure
post coronary artery bypass graft patients
ARDS
acute kidney injury
burn injury
trauma injury
lay SUPINE or TRENDELENBURG
place at phlebostatic axis (4th intercostal space, midaxillary line)
Hemodynamic Monitoring Findings
central venous pressure = 1-8
pulmonary artery systolic = 15-25
, pulmonary artery diastolic = 5-15
pulmonary artery wedge pressure = 4-12
mixed venous oxygen saturation = 60-80%
Hemodynamic Monitoring Complications
infection/sepsis -
surgical asepsis when changing dressing (mask, sterile globes, maintain sterile fiedl)
embolism
0.9% sodium chloride for flushing (NO heparin)
Angiography
a radiographic study of the blood vessels after the injection of a contrast medium
indications:
unstable angina
ECG changes
NPO for at least 8 hrs
watch for iodine/shellfish ALLERGY
assess RENAL function
AFTER: maintain bed rest, keep extremity STRAIGHT
Angiography Teaching
no strenous exercise
report bleeding
restrict lifting (<10 lb)
anticoagulation therapy (those who have stent placement)
Angiography Complications
cardiac tamponade
hematoma formation
restenosis of treated vessel
retroperitoneal bleeding
Vascular Access
central catheters:
- nontunneled percutaneous central catheter -
(chemotherapy, blood, antibiotics, TPN)
LONG TERM
- peripherally inserted central catheter -
use up to 12 months
(blood, chemotherapy, antibiotics, TPN)
assess site q 8 hrs
change tube and positive pressure cap at least q 3 days
10 mL or larger syringe to flush
flush with 10 mL of 0.9% sodium chloride
transparent dressing
do NOT immerse in water
NO blood pressure on PICC arm
- tunneled percutaneous central catheter -
long term use
NO dressing needed
- implanted port -
long term (> 1 yr)
