Diagnostic Tests for Cardiovascular Issues

May 16, 2024

Cardiovascular Diagnostic Tests - Summary

Presenter

  • Cathy, Level Up RN

Topics Covered

  1. Overview of Cardiovascular Diagnostic Procedures
  2. Electrocardiogram (EKG)
  3. Echocardiogram
  4. Transesophageal Echocardiogram (TEE)
  5. Hemodynamic Monitoring
  6. Coronary Angiogram (Cardiac Cath)

Electrocardiogram (EKG)

  • Provides a graphic representation of the heart's electrical activity.
  • Useful for diagnosing a variety of heart conditions.
  • Additional resources: EKG flashcards and video playlist.

Echocardiogram

  • Uses ultrasound waves to visualize cardiac structures, especially heart valves.
  • Measures ejection fraction (normal: 55-70%).
  • Reduced ejection fraction indicates heart failure.

Transesophageal Echocardiogram (TEE)

  • A more detailed view of cardiac structures via a transducer placed down the esophagus.
  • Conducted under conscious sedation.

Hemodynamic Monitoring

  • Provides direct measurement of pressures in the heart and great vessels through an arterial line.
  • Measures include:
    • Central Venous Pressure (CVP): 2-6 mmHg
    • Pulmonary Artery Wedge Pressure (PAWP): 4-12 mmHg
    • Cardiac Output

Coronary Angiogram (Cardiac Cath)

  • Used to determine blockages or narrowing of coronary arteries.
  • Procedure:
    • Catheter inserted at femoral artery and threaded to the heart.

Pre-Procedure Nursing Care

  • Patient NPO for 8+ hours.
  • Assess for allergies to iodine and shellfish (though evidence on this is mixed).
  • Assess kidney function (creatinine and BUN levels).
  • Mark distal pulses (dorsal pedis, posterior tibial).

Post-Procedure Nursing Care

  • Check insertion site for bleeding.
  • Check extremity distal to insertion site for pulse, capillary refill, color, and temperature.
  • Monitor vital signs per facility policy:
    • Every 15 min for the first hour.
    • Every hour for the next four hours.
  • Encourage increased fluid intake to flush out contrast dye.
  • Patient should lay flat for 4-6 hours.

Quiz Questions

  1. What procedure uses ultrasound waves to visualize cardiac structures and measure ejection fraction?
    • Answer: Echocardiogram
  2. What lab values are used to assess a patient's kidney function prior to a cardiac cath?
    • Answer: Creatinine and BUN (Creatinine is more important)
  3. How should a patient be positioned after a cardiac cath?
    • Answer: Lay flat for 4-6 hours.

Next Steps

  • Next video will cover dysrhythmias.

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