Cardiac Stress Testing and TEE Overview
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Questions and Answers

What is the purpose of administering vasodilating agents like Dipyridamole during a pharmacological stress test?

  • To reduce the heart rate before the test
  • To mimic the effects of exercise by dilating coronary arteries (correct)
  • To increase blood pressure during the test
  • To prevent dizziness and nausea during the procedure

    • What should be avoided for 10-12 hours after a cardiac stress test?

  • High-sugar foods
  • Caffeine consumption
  • Physical exercise
  • Taking hot showers (correct)

    • Which side effects are associated with both Dipyridamole and Adenosine during pharmacological stress testing?

  • Increased appetite and insomnia
  • Chest discomfort, flushing, nausea, and dizziness (correct)
  • Shortness of breath and palpitations
  • Hypotension and tachycardia

    • What is the maximum duration of effect for Adenosine when administered during a stress test?

    <p>Less than 10 seconds</p> Signup and view all the answers

    Why must patients avoid caffeine before a pharmacological stress test?

    <p>It may block the effects of dipyridamole and adenosine</p> Signup and view all the answers

    What is the recommended fasting duration before undergoing a cardiac stress test?

    <p>4 hours</p> Signup and view all the answers

    Which medication should patients discontinue 24 to 48 hours before the stress test to prevent interference?

    <p>Methylxanthines</p> Signup and view all the answers

    What is the primary function of a transesophageal echocardiogram (TEE)?

    <p>To assess the heart's function and structures</p> Signup and view all the answers

    What does the QRS complex primarily represent?

    <p>Ventricular depolarization</p> Signup and view all the answers

    Which condition does NOT typically indicate the use of transesophageal echocardiography?

    <p>Urinary tract infection</p> Signup and view all the answers

    Which wave is characterized as the first positive deflection after the P wave in the QRS complex?

    <p>R wave</p> Signup and view all the answers

    What is a possible consequence of congestive heart failure?

    <p>Fluid buildup in various body areas</p> Signup and view all the answers

    What is the maximum normal duration of the QRS complex?

    <p>0.12 seconds</p> Signup and view all the answers

    Which of the following conditions is associated with the presence of a U wave?

    <p>Hypokalemia</p> Signup and view all the answers

    Which of the following describes a key characteristic of atherosclerosis?

    <p>Gradual clogging of arteries</p> Signup and view all the answers

    Which patient condition should be evaluated carefully before undergoing transesophageal echocardiography?

    <p>Known esophageal varices</p> Signup and view all the answers

    What does the T wave in an electrocardiogram indicate?

    <p>Ventricular repolarization</p> Signup and view all the answers

    In the context of the QRS complex, when are capital letters used for the waves?

    <p>When the wave is taller than 5mm</p> Signup and view all the answers

    What can result from valvular heart disease?

    <p>Obstruction of blood flow within the heart</p> Signup and view all the answers

    What is the normal height for a P wave in an electrocardiogram?

    <p>2.5 mm or less</p> Signup and view all the answers

    What is a typical characteristic of an aneurysm?

    <p>Dilation of heart muscle or aorta</p> Signup and view all the answers

    Which of these is NOT a nursing intervention prior to the transesophageal echocardiography?

    <p>Treat underlying respiratory issues</p> Signup and view all the answers

    What follows the QRS complex in a standard electrocardiogram?

    <p>T wave</p> Signup and view all the answers

    Which of the following is a contraindication for transesophageal echocardiography?

    <p>Pregnancy</p> Signup and view all the answers

    What is the primary goal of right heart catheterization?

    <p>To monitor pressures and oxygen saturation in the right heart</p> Signup and view all the answers

    Which factor is essential for conducting myocardial perfusion imaging effectively?

    <p>Placement of an IV line for radioisotope administration</p> Signup and view all the answers

    What does a fixed defect in myocardial perfusion imaging indicate?

    <p>Permanent damage to the myocardium due to previous myocardial infarction</p> Signup and view all the answers

    How does myocardial perfusion imaging benefit patients post-myocardial infarction?

    <p>It assesses whether arterial perfusion to the heart is compromised during activity</p> Signup and view all the answers

    Which artery is not specifically mentioned in the right heart catheterization process?

    <p>Radial artery</p> Signup and view all the answers

    In what manner is myocardial perfusion imaging typically performed?

    <p>By comparing resting and stressed images of the heart</p> Signup and view all the answers

    Why are electrodes placed on the chest during myocardial perfusion imaging?

    <p>To monitor the patient's heart rate and rhythm</p> Signup and view all the answers

    What is the primary purpose of stress testing during myocardial perfusion imaging?

    <p>To assess the heart’s perfusion under physical strain</p> Signup and view all the answers

    What is the maximum dosage of atropine that can be administered for symptomatic bradycardia?

    <p>3 mg</p> Signup and view all the answers

    Which of the following accurately describes the characteristics of sinus tachycardia?

    <p>Ventricular rate is usually greater than 100 bpm</p> Signup and view all the answers

    What is the P to QRS ratio in a normal ECG reading?

    <p>1:1</p> Signup and view all the answers

    How does atropine affect the heart rate in cases of symptomatic bradycardia?

    <p>It allows a normal rate to occur</p> Signup and view all the answers

    Which statement about sinus arrhythmia is correct?

    <p>It occurs when the sinus node creates impulses at an irregular rate.</p> Signup and view all the answers

    What physiological factors can cause sinus tachycardia?

    <p>Dehydration</p> Signup and view all the answers

    What is the typical duration of the PR interval in a normal ECG?

    <p>Between 0.12 and 0.20 seconds</p> Signup and view all the answers

    Which of the following describes the P wave in a normal ECG reading?

    <p>Normal and consistent shape, always before the QRS complex</p> Signup and view all the answers

    Study Notes

    Cardiac Stress Testing

    • Target Heart Rate: Instruct clients to avoid hot showers for 10-12 hours after testing.

    • Pharmacological Stress Test: Uses two vasodilating agents:

      • Dipyridamole (Persantine): Lasts 15-30 minutes; side effects include chest discomfort, flushing, nausea, and dizziness.
      • Adenosine (Adenocard): Lasts less than 10 seconds; has similar side effects to dipyridamole.

    • Nursing Interventions:

      • Fasting for 4 hours before the test; avoid alcohol and caffeine.
      • Reschedule if caffeine has been ingested prior.
      • Patients on methylxanthines must stop for 24-48 hours to not block medication effects.
      • The entire stress test may take about 1 hour.

    Transesophageal Echocardiography (TEE)

    • Purpose: Assesses heart function and structures using echocardiography.

    • Indications: Evaluates conditions like:

      • Atherosclerosis: Gradual clogging of arteries.
      • Cardiomyopathy: Heart muscle thickening or weakening.
      • Congenital heart disease: Structural defects from fetal development.
      • Congestive heart failure: Weakened heart leading to blood flow inefficiency.
      • Aneurysm: Dilation causing tissue weakness.
      • Valvular heart disease: Malfunctioning heart valves obstructing blood flow.

    • Contraindications:

      • Known esophageal problems, pregnant individuals.

    • Nursing Interventions:

      • Secure informed consent; explain the procedure to clients.

    Right Heart Catheterization

    • Procedure: Catheter inserted from femoral or antecubital artery into the right side of the heart.
    • Monitoring: Assessing pressures and oxygen saturation across heart chambers.

    Myocardial Perfusion Imaging

    • Use: Combined with stress testing to compare resting and stressed hearts.

    • Procedure:

      • Client positioned on back with arms overhead; IV for radioisotope administration.
      • Electrodes placed to monitor heart rate/rhythm.
      • Commonly performed post-myocardial infarction to evaluate arterial perfusion.

    • Results:

      • Defect: No or reduced heart perfusion areas.
      • Fixed Defect: Indicates non-perfusion post-MI.

    Electrocardiogram (ECG) Interpretation

    • Waves, Complexes, and Intervals:

      • QRS Complex: Represents ventricular depolarization; duration <0.12 seconds.
      • T Wave: Indicates ventricular repolarization; follows QRS.
      • U Wave: Reflects repolarization of Purkinje fibers; often seen with hypokalemia.
      • P Wave: Consistent shape before QRS; PR interval 0.12-0.20 seconds.

    • Rhythm Dysrhythmias:

      • Sinus Bradycardia: Symptoms include shakiness and hypotension; treat with atropine.
      • Sinus Tachycardia: Heart rate >100 bpm; caused by stress or medications.
      • Sinus Arrhythmia: Irregular impulse rate; increases with inspiration, decreases with expiration.

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    Description

    This quiz covers essential aspects of cardiac stress testing and transesophageal echocardiography (TEE). It includes details on target heart rates, pharmacological stress tests, nursing interventions, and the purpose and indications for TEE. Test your knowledge on these vital cardiac assessment techniques.

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