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NSG 223 MED SURG 2 exam 1 with Verified Answers

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NSG 223 MED SURG 2 exam 1 with Verified Answers 1. What is cardiac stress test?: the patient walks or runs on a treadmill (most common) or pedals a stationary bicycle. The test is stopped when the target heart rate is achieved or if the patient experi- ences signs of myocardial ischemia. Abnormal findings include chest pain ventricular arrhythmia ST-segment depression lack of heart rate or BP elevation with exercise 2. What is pharmacological stress test: Patients who are cognitively impaired and unable to follow directions or physically disabled or deconditioned will not be able to achieve their target heart rate by exerc

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NSG 223 MED SURG 2 exam 1 with Verified Answers
1. What is cardiac stress test?: the patient walks or runs on a treadmill (most
common) or pedals a stationary bicycle.

The test is stopped when the target heart rate is achieved or if the patient experi-
ences signs of myocardial ischemia.

Abnormal findings include
chest pain
ventricular arrhythmia
ST-segment depression
lack of heart rate or BP elevation with exercise
2. What is pharmacological stress test: Patients who are cognitively impaired and
unable to follow directions or physically disabled or deconditioned will not be able to
achieve their target heart rate by exercising on a treadmill or bicycle.

must avoid xanthine derivatives (theophylline, aminophylline, caffeine) for 24-48hrs
prior (they block the effects of the vasodilating agents.)

NPO 3 hrs b4, abstain from all caffeine 24 hrs prior. Including chocolate and caffeine
free beverages ( tea)
3. What medications are use for pharmacological stress t testing?: Vasodilating
agents such as
dipyridamole,
adenosine
Or regadenoson given as an IV
Dobutamine

used to mimic the effects of exercise by maximally dilating normal coronary arteries
and identifying stenotic arteries that cannot vasodilate. The side effects of these
agents are related to the vasodilating action and include chest pain, headache,
flushing, nausea, heart block, and dyspnea

these drugs can be reversed with IV aminophylline. Adenosine has an extremely
short half-life (less than 10 seconds), so any severe effects subside rapidly
4. Nursing interventions for TEE: instructs the patient not to eat or drink anything
for 6 hours prior to the study

recovery period, the patient must maintain bed rest with the head of the bed elevated
to 45 degrees


, NSG 223 MED SURG 2 exam 1 with Verified Answers

monitors the patient for dyspnea and assesses vital signs, SpO2, level of conscious-
ness, and gag reflex as recommended

sore throat may be present for the next 24 hours

report the presence of a persistent sore throat, shortness of breath, or difficulty
swallowing
5. What test is contradictory to a patient who had an acute MI?: Exercise stress
test

Contraindicated 48hrs after an Acute Myocardial Infarction

pt must be capable of walking on a treadmill, or a stationary bike

- NPO 3+ hrs before, avoid stimulants too
6. What is a echocardiogram?: Echocardiography involves transmission of
high-frequency sound waves into the heart through the chest wall and the recording
of the return signals
7. Examples of echocardiography: Transthoracic Echocardiography
involves transmission of high-frequency sound waves into the heart through the
chest wall and the recording of the return signals

Transesophageal Echocardiography TEE
technique involves threading a small transducer through the mouth and into the
esophagus.A topical anesthetic agent and sedation are used
8. Labs to diagnosed MI: Elevated tropinin
Elevated creating kinase-MB ( CK MB)
9. What would be appreciated for a patient with A-fib: Nurse should turn off
irregular hear rate alarm
10. What the nurse should monitor while the patient is exercise stress testing-
: two or more ECG leads for heart rate
rhythm and ischemic changes
BP
skin temperature
physical appearance
perceived exertion; and symptoms, including chest pain, dyspnea, dizziness, leg
cramping, and fatigue



, NSG 223 MED SURG 2 exam 1 with Verified Answers
the patient is instructed to fast for several hours before the test and to avoid
stimulants such as tobacco and caffeine

After the test patient is monitored for 10 to 15mint unitl return to normal
11. What is cardiac catheterization?: It is an invasive procedure used to visualize
the heart's chambers, valves, great vessels and coronary arteries.




12. What is catheter ablation therapy ?: Catheter ablation destroys specific cells
that are the cause of a tachyarrhythmia.
where high-frequency, low-energy sound waves are passed through the catheter,
causing thermal injury, localized cell destruction, and scarring

Electrode-tipped ablation catheter "burns" accessory pathways or ec topic sites in
the atria, AV node, and ventricles.

Most often use for Atrial fibrillation
13. What is left atrial appendage occlusion also known WATCHMAN ?: LAAO
is an alternative to antithrombotic medications for stroke prevention in patients with
nonvalvular atrial fibrillation.

the LAA is the area where the majority of stroke-causing blood clots form in patients
with nonvalvular atrial fibrillation. However, concerns about the risk oflong-term
anticoagulant use and the risk of bleeding can complicate effective management

WATCHMAN, a device typically inserted while the patient is under general anesthe-
sia.

Patients are prescribed aspirin
14. What is atrial fibrillation?: RATE may vary
Atrial Rate: 350 to 600 bpm
Ventricular Rate: 120 to 200 bpm
P wave is not discernible with an irregular baseline
PR interval is not measurable
QRS complex is normal
Rhythm is irregular and usually rapid unless controlled.

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