CARDIAC ATI STUDY GUIDE UPADTED QUESTIONS AND
ANSWERS GRADED A+
✔✔Signs of cardiac tamponade - ✔✔hypotension, JVD, paradoxical pulse (change on
inspiration/expiration), muffled heart sounds
✔✔Name to common drugs used for conscious sedation - ✔✔Versed & Valium
✔✔T/F: CABG alters the atherosclerotic process - ✔✔False. It improves the quality of
life
✔✔Indications for CABG - ✔✔Bypass blockages 70% or more (notes say 70%, ATI
says 50%)
Most effective when adequate ventricular function remains and EF greater than 50%
✔✔Post-Op care of CABG patient (notes) - ✔✔Management of F&E balance—(priority)
monitor for electrolytes and edema
Hypotension (systolic less than 90)—give fluids or blood volume, inotropes
Hypothermia—rewarm with blankets, lights, bear hugger—do not let shiver
Bleeding—occurs in all patients; if over 150 ml in chest tube call Dr.,
✔✔Meds frequently DQed prior to surgery (CABG) - ✔✔Diuretics 2-3 days before
surgery
Aspirin and other anticoagulants 1 week before surgery
✔✔Meds usually continued regularly before CABG - ✔✔K+, antidysrhythmics
(amiodorone), beta-blockers and calcium-channel blockers, insulin
✔✔Post-Op care of CABG patient (ATI) - ✔✔Maintain patent airway and adequate
ventilation
Teach splinting, coughing and deep breathing, incentive spirometry
Dangle w/in 2 hr following extubation, assist to chair w/in 24 hrs, ambulate early
Monitor BP, level of consciousness, neuro status
Monitor chest tube patency and drainage (150mL+/hr = call DR)
Assess and control pain (frequent and adequate doses)
Monitor fluid and electrolyte status
✔✔Anginal Pain often _______ and is ______ by ________. - ✔✔radiates and is
unaffected by breathing
✔✔Describe heart-healthy diet - ✔✔low fat, low cholesterol, high fiber, low salt
, ✔✔Signs of peripheral artery disease - ✔✔numbness/burning pain to extremity w
exercise, intermittent claudication
pain that may wake client at night - may be relieved by lowering below heart level
absent pedal pulse, dry, hairless, shiny skin
skin may be cold and dark colored, thick toenails
✔✔Signs of MI common in women and older adults - ✔✔indigestion and shortness of
breath, jaw/back pain
✔✔Caused by coronary artery spasm, often occurring at rest - ✔✔Variant angina
✔✔Difference between ischemia and infarction - ✔✔ischemia is temporary and
reversible
✔✔Difference between angina and MI - ✔✔Angina:
precipitated by exertion/stress, relieved by rest/nitro, less than 15 mins
MI:
can occur w/o cause, relieved only by opiods, symptoms last greater than 15
mins/30mins
associated w/ nausea, GI distress, dyspnea, anxiety, sweating
✔✔Earliest marker of injury to cardiac or skeletal muscle (first 24 hrs) - ✔✔Myoglobin
✔✔Peaks around 24 hr after chest pain, no longer evident after 3 days - ✔✔CK-MB
✔✔Patient education regarding chest pain: - ✔✔stop activity and rest
place nitro tablet under tongue (will tingle)
if pain is unrelieved in 5 mins, call 911
Can take up to 3 doses of nitro at 5 min intervals
✔✔Common side effect of nitro - ✔✔headache
✔✔Drugs that reduce afterload and slow heart rate - ✔✔beta-blockers
✔✔When taking beta-blockers, notify provider of: - ✔✔SOB, edema, weight gain, cough
✔✔Normal pTT rate - ✔✔25-35 seconds
✔✔Aspirin prevents ______________ - ✔✔vasoconstriction
ANSWERS GRADED A+
✔✔Signs of cardiac tamponade - ✔✔hypotension, JVD, paradoxical pulse (change on
inspiration/expiration), muffled heart sounds
✔✔Name to common drugs used for conscious sedation - ✔✔Versed & Valium
✔✔T/F: CABG alters the atherosclerotic process - ✔✔False. It improves the quality of
life
✔✔Indications for CABG - ✔✔Bypass blockages 70% or more (notes say 70%, ATI
says 50%)
Most effective when adequate ventricular function remains and EF greater than 50%
✔✔Post-Op care of CABG patient (notes) - ✔✔Management of F&E balance—(priority)
monitor for electrolytes and edema
Hypotension (systolic less than 90)—give fluids or blood volume, inotropes
Hypothermia—rewarm with blankets, lights, bear hugger—do not let shiver
Bleeding—occurs in all patients; if over 150 ml in chest tube call Dr.,
✔✔Meds frequently DQed prior to surgery (CABG) - ✔✔Diuretics 2-3 days before
surgery
Aspirin and other anticoagulants 1 week before surgery
✔✔Meds usually continued regularly before CABG - ✔✔K+, antidysrhythmics
(amiodorone), beta-blockers and calcium-channel blockers, insulin
✔✔Post-Op care of CABG patient (ATI) - ✔✔Maintain patent airway and adequate
ventilation
Teach splinting, coughing and deep breathing, incentive spirometry
Dangle w/in 2 hr following extubation, assist to chair w/in 24 hrs, ambulate early
Monitor BP, level of consciousness, neuro status
Monitor chest tube patency and drainage (150mL+/hr = call DR)
Assess and control pain (frequent and adequate doses)
Monitor fluid and electrolyte status
✔✔Anginal Pain often _______ and is ______ by ________. - ✔✔radiates and is
unaffected by breathing
✔✔Describe heart-healthy diet - ✔✔low fat, low cholesterol, high fiber, low salt
, ✔✔Signs of peripheral artery disease - ✔✔numbness/burning pain to extremity w
exercise, intermittent claudication
pain that may wake client at night - may be relieved by lowering below heart level
absent pedal pulse, dry, hairless, shiny skin
skin may be cold and dark colored, thick toenails
✔✔Signs of MI common in women and older adults - ✔✔indigestion and shortness of
breath, jaw/back pain
✔✔Caused by coronary artery spasm, often occurring at rest - ✔✔Variant angina
✔✔Difference between ischemia and infarction - ✔✔ischemia is temporary and
reversible
✔✔Difference between angina and MI - ✔✔Angina:
precipitated by exertion/stress, relieved by rest/nitro, less than 15 mins
MI:
can occur w/o cause, relieved only by opiods, symptoms last greater than 15
mins/30mins
associated w/ nausea, GI distress, dyspnea, anxiety, sweating
✔✔Earliest marker of injury to cardiac or skeletal muscle (first 24 hrs) - ✔✔Myoglobin
✔✔Peaks around 24 hr after chest pain, no longer evident after 3 days - ✔✔CK-MB
✔✔Patient education regarding chest pain: - ✔✔stop activity and rest
place nitro tablet under tongue (will tingle)
if pain is unrelieved in 5 mins, call 911
Can take up to 3 doses of nitro at 5 min intervals
✔✔Common side effect of nitro - ✔✔headache
✔✔Drugs that reduce afterload and slow heart rate - ✔✔beta-blockers
✔✔When taking beta-blockers, notify provider of: - ✔✔SOB, edema, weight gain, cough
✔✔Normal pTT rate - ✔✔25-35 seconds
✔✔Aspirin prevents ______________ - ✔✔vasoconstriction
