Podcast
Questions and Answers
What is the purpose of administering vasodilating agents like Dipyridamole during a pharmacological stress test?
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?
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?
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?
What is the maximum duration of effect for Adenosine when administered during a stress test?
Why must patients avoid caffeine before a pharmacological stress test?
Why must patients avoid caffeine before a pharmacological stress test?
What is the recommended fasting duration before undergoing a cardiac stress test?
What is the recommended fasting duration before undergoing a cardiac stress test?
Which medication should patients discontinue 24 to 48 hours before the stress test to prevent interference?
Which medication should patients discontinue 24 to 48 hours before the stress test to prevent interference?
What is the primary function of a transesophageal echocardiogram (TEE)?
What is the primary function of a transesophageal echocardiogram (TEE)?
What does the QRS complex primarily represent?
What does the QRS complex primarily represent?
Which condition does NOT typically indicate the use of transesophageal echocardiography?
Which condition does NOT typically indicate the use of transesophageal echocardiography?
Which wave is characterized as the first positive deflection after the P wave in the QRS complex?
Which wave is characterized as the first positive deflection after the P wave in the QRS complex?
What is a possible consequence of congestive heart failure?
What is a possible consequence of congestive heart failure?
What is the maximum normal duration of the QRS complex?
What is the maximum normal duration of the QRS complex?
Which of the following conditions is associated with the presence of a U wave?
Which of the following conditions is associated with the presence of a U wave?
Which of the following describes a key characteristic of atherosclerosis?
Which of the following describes a key characteristic of atherosclerosis?
Which patient condition should be evaluated carefully before undergoing transesophageal echocardiography?
Which patient condition should be evaluated carefully before undergoing transesophageal echocardiography?
What does the T wave in an electrocardiogram indicate?
What does the T wave in an electrocardiogram indicate?
In the context of the QRS complex, when are capital letters used for the waves?
In the context of the QRS complex, when are capital letters used for the waves?
What can result from valvular heart disease?
What can result from valvular heart disease?
What is the normal height for a P wave in an electrocardiogram?
What is the normal height for a P wave in an electrocardiogram?
What is a typical characteristic of an aneurysm?
What is a typical characteristic of an aneurysm?
Which of these is NOT a nursing intervention prior to the transesophageal echocardiography?
Which of these is NOT a nursing intervention prior to the transesophageal echocardiography?
What follows the QRS complex in a standard electrocardiogram?
What follows the QRS complex in a standard electrocardiogram?
Which of the following is a contraindication for transesophageal echocardiography?
Which of the following is a contraindication for transesophageal echocardiography?
What is the primary goal of right heart catheterization?
What is the primary goal of right heart catheterization?
Which factor is essential for conducting myocardial perfusion imaging effectively?
Which factor is essential for conducting myocardial perfusion imaging effectively?
What does a fixed defect in myocardial perfusion imaging indicate?
What does a fixed defect in myocardial perfusion imaging indicate?
How does myocardial perfusion imaging benefit patients post-myocardial infarction?
How does myocardial perfusion imaging benefit patients post-myocardial infarction?
Which artery is not specifically mentioned in the right heart catheterization process?
Which artery is not specifically mentioned in the right heart catheterization process?
In what manner is myocardial perfusion imaging typically performed?
In what manner is myocardial perfusion imaging typically performed?
Why are electrodes placed on the chest during myocardial perfusion imaging?
Why are electrodes placed on the chest during myocardial perfusion imaging?
What is the primary purpose of stress testing during myocardial perfusion imaging?
What is the primary purpose of stress testing during myocardial perfusion imaging?
What is the maximum dosage of atropine that can be administered for symptomatic bradycardia?
What is the maximum dosage of atropine that can be administered for symptomatic bradycardia?
Which of the following accurately describes the characteristics of sinus tachycardia?
Which of the following accurately describes the characteristics of sinus tachycardia?
What is the P to QRS ratio in a normal ECG reading?
What is the P to QRS ratio in a normal ECG reading?
How does atropine affect the heart rate in cases of symptomatic bradycardia?
How does atropine affect the heart rate in cases of symptomatic bradycardia?
Which statement about sinus arrhythmia is correct?
Which statement about sinus arrhythmia is correct?
What physiological factors can cause sinus tachycardia?
What physiological factors can cause sinus tachycardia?
What is the typical duration of the PR interval in a normal ECG?
What is the typical duration of the PR interval in a normal ECG?
Which of the following describes the P wave in a normal ECG reading?
Which of the following describes the P wave in a normal ECG reading?
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Study Notes
Cardiac Stress Testing
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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.
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Contraindications:
- Known esophageal problems, pregnant individuals.
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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
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Use: Combined with stress testing to compare resting and stressed hearts.
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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.
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Results:
- Defect: No or reduced heart perfusion areas.
- Fixed Defect: Indicates non-perfusion post-MI.
Electrocardiogram (ECG) Interpretation
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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.
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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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