NURS 480 Exam 2 | Questions and Answers
Verified 100% Correct
What is angiography? - ANSWER -An invasive procedure used to evaluate the
degree and presence of coronary artery blockage. A renal, liver, cerebral, upper and
lower extremities angiogram can be done to determine blood flow and areas of
possible blockage of a vessel. It involves insertion of the catheter into femoral,
brachial, or radial vessel and threading into the right or left side of the heart
How can artery narrows and/or occlusions be identified in angiography? -
ANSWER -Injection of contrast media under fluoroscopy
What are indications for angiography? - ANSWER -Unstable angina and ECG
changes
Confirm and determine location and extent of heart disease
What are postprocedure considerations for angiography? - ANSWER -Assess VS
Q15M x 4, Q30M x 2, Q1H x 1, then Q4H per facility protocol
Perform neurovascular checks at the same intervals as VS to assess for bleeding
and thrombosis (document pedal pulse, extremity color, and temp)
Bed rest in supine position, typically for 6-8 hrs, with extremity straight for
prescribed time
Continuous cardiac monitoring for dysrhythmias
Administer antiplatelet or thrombolytics as prescribed to prevent clots and
restenosis (Aspirin, Clopidogrel or Plavix, Heparin, Enoxaparin or Lovenox, GP
IIb/IIIa inhibitors such as eptifibatide)
Administer anxiolytics and analgesics PRN
Monitor urine output and give IVF for hydration
,Perform/assist with sheath removal
Apply pressure to arterial/venous sites for prescribed time, apply pressure dressing
Observe for vagal response (hypotension, bradycardia)
What kind of meds will patients with stents receive with angigraphy? - ANSWER
-Anticoagulants
What are pre op considerations for a coronary artery bypass graft (CABG)? -
ANSWER -Is it elective or emergent?
Consent form
Confirm that recent chest x-ray, EKG, and labs are obtained
Baseline assessment
Assess client and family anxiety levels
Educate on recovery expectations, which are endotracheal tube and mechanical
ventilation for airway management, inability to talk while endotracheal is in place,
early ambulation to prevent complications, hemodynamic monitoring devices, and
indwelling urinary cath
What are intra op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Median sternotomy incision is made to visualize heart and vessels
Client is placed on cardiopulmonary bypass, and the client's core temp can be
lowered to decrease the rate of metabolism and demand for oxygen
Cardioplegic solution is sued to stop the heart to prevent myocardial ischemia
Artery or vein is harvested and will be used as a graft
Pacemaker wire are sutured into the myocardium and chest tubes are placed
What are post op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Maintain patent airway and adequate ventilation
,Continuous hemodynamic monitoring
Monitor VS and labs
Manage IV meds per protocol
Monitor chest tube patency and drainage, volume exceeding 150 mL/hr could be a
manifestation of hemorrhage
Pain management, splint, meds, enhance breathing
Infection prevention
Encourage mobility: get out of bed, use of incentive spirometer
What are complications of coronary artery bypass graft (CABG)? - ANSWER -
Pulmonary complications, such as atelectasis and PNA
Decreased CO
Hypothermia
Electrolyte disturbances, K and Mg depletion is common
Neurologic defects
Clots are common
Stroke
What are dysrhythmias? - ANSWER -Abnormal heart rhythms
Can directly decrease CO by changing stroke volume and HR
Recognition is critical in maintaining adequate perfusion
What does the conduction system of the heart do? - ANSWER -Starts electrical
impulse at sinoatrial (SA) node and sends it through the heart tissue to get to the
atrioventricular (AV) node. It then travels through the bundle of His, to the
purkinje fibers, causing ventricle contractions
, What happens when the vagus nerve is stimulated? - ANSWER -Decrease HR
What happens if the sympathetic nerves are stimulated? - ANSWER -Increase HR
Describe depolarization - ANSWER -Na+ moves into the cells making the inside
of the cells positively charged compared to outside
Cells contract and push blood through the heart
Describe repolarization - ANSWER -Closing of Na+ channels and opening of K+
channels
Cells become negatively charged again, heart is relaxing
What does the P wave represent? - ANSWER -atrial depolarization
What does the QRS complex/interval rpresent? - ANSWER -Depolarization of
both ventricles
What is electrocardiographic monitoring? - ANSWER -Graphic tracing of
electrical impulses produced in the heart
What are the steps to analyzing EKG? - ANSWER -1. determine HR
2. determine if rhythm is regular or irregular
3. determine P wave regularity and shape
4. measure PR interval
5. measure QRS duration, check consistency in appearance
6. examine ST segment, depression or elevation
7. assess T wave
8. measure QT interval
ST elevation indicates? - ANSWER -MI
Verified 100% Correct
What is angiography? - ANSWER -An invasive procedure used to evaluate the
degree and presence of coronary artery blockage. A renal, liver, cerebral, upper and
lower extremities angiogram can be done to determine blood flow and areas of
possible blockage of a vessel. It involves insertion of the catheter into femoral,
brachial, or radial vessel and threading into the right or left side of the heart
How can artery narrows and/or occlusions be identified in angiography? -
ANSWER -Injection of contrast media under fluoroscopy
What are indications for angiography? - ANSWER -Unstable angina and ECG
changes
Confirm and determine location and extent of heart disease
What are postprocedure considerations for angiography? - ANSWER -Assess VS
Q15M x 4, Q30M x 2, Q1H x 1, then Q4H per facility protocol
Perform neurovascular checks at the same intervals as VS to assess for bleeding
and thrombosis (document pedal pulse, extremity color, and temp)
Bed rest in supine position, typically for 6-8 hrs, with extremity straight for
prescribed time
Continuous cardiac monitoring for dysrhythmias
Administer antiplatelet or thrombolytics as prescribed to prevent clots and
restenosis (Aspirin, Clopidogrel or Plavix, Heparin, Enoxaparin or Lovenox, GP
IIb/IIIa inhibitors such as eptifibatide)
Administer anxiolytics and analgesics PRN
Monitor urine output and give IVF for hydration
,Perform/assist with sheath removal
Apply pressure to arterial/venous sites for prescribed time, apply pressure dressing
Observe for vagal response (hypotension, bradycardia)
What kind of meds will patients with stents receive with angigraphy? - ANSWER
-Anticoagulants
What are pre op considerations for a coronary artery bypass graft (CABG)? -
ANSWER -Is it elective or emergent?
Consent form
Confirm that recent chest x-ray, EKG, and labs are obtained
Baseline assessment
Assess client and family anxiety levels
Educate on recovery expectations, which are endotracheal tube and mechanical
ventilation for airway management, inability to talk while endotracheal is in place,
early ambulation to prevent complications, hemodynamic monitoring devices, and
indwelling urinary cath
What are intra op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Median sternotomy incision is made to visualize heart and vessels
Client is placed on cardiopulmonary bypass, and the client's core temp can be
lowered to decrease the rate of metabolism and demand for oxygen
Cardioplegic solution is sued to stop the heart to prevent myocardial ischemia
Artery or vein is harvested and will be used as a graft
Pacemaker wire are sutured into the myocardium and chest tubes are placed
What are post op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Maintain patent airway and adequate ventilation
,Continuous hemodynamic monitoring
Monitor VS and labs
Manage IV meds per protocol
Monitor chest tube patency and drainage, volume exceeding 150 mL/hr could be a
manifestation of hemorrhage
Pain management, splint, meds, enhance breathing
Infection prevention
Encourage mobility: get out of bed, use of incentive spirometer
What are complications of coronary artery bypass graft (CABG)? - ANSWER -
Pulmonary complications, such as atelectasis and PNA
Decreased CO
Hypothermia
Electrolyte disturbances, K and Mg depletion is common
Neurologic defects
Clots are common
Stroke
What are dysrhythmias? - ANSWER -Abnormal heart rhythms
Can directly decrease CO by changing stroke volume and HR
Recognition is critical in maintaining adequate perfusion
What does the conduction system of the heart do? - ANSWER -Starts electrical
impulse at sinoatrial (SA) node and sends it through the heart tissue to get to the
atrioventricular (AV) node. It then travels through the bundle of His, to the
purkinje fibers, causing ventricle contractions
, What happens when the vagus nerve is stimulated? - ANSWER -Decrease HR
What happens if the sympathetic nerves are stimulated? - ANSWER -Increase HR
Describe depolarization - ANSWER -Na+ moves into the cells making the inside
of the cells positively charged compared to outside
Cells contract and push blood through the heart
Describe repolarization - ANSWER -Closing of Na+ channels and opening of K+
channels
Cells become negatively charged again, heart is relaxing
What does the P wave represent? - ANSWER -atrial depolarization
What does the QRS complex/interval rpresent? - ANSWER -Depolarization of
both ventricles
What is electrocardiographic monitoring? - ANSWER -Graphic tracing of
electrical impulses produced in the heart
What are the steps to analyzing EKG? - ANSWER -1. determine HR
2. determine if rhythm is regular or irregular
3. determine P wave regularity and shape
4. measure PR interval
5. measure QRS duration, check consistency in appearance
6. examine ST segment, depression or elevation
7. assess T wave
8. measure QT interval
ST elevation indicates? - ANSWER -MI
