NURS 480 Exam 2 | Questions and Answers
Verified 100% Correct
What is stress testing? - ANSWER -Client exercises the cardiac muscles by
walking on a treadmill
How is a pulmonary artery catheter instered? - ANSWER -Into a large vein
(internal jugular, femoral, subclavian, brachial) and threaded through the right atria
and ventricle into a branch of the PA
PA catheters have multiple lumens and components. What are they and what are
they used for? - ANSWER -Proximal Lumen: measures right atrial pressure
(central venous pressure or CVP), infuse IV fluids, and obtain venous blood
samples
Distal Lumen: Measures PAP (PA systolic, PA diastolic, mean PA pressure, and
PA wedge pressure), NOT USED FOR IV FLUIDS
Balloon Inflation Port: PAWP measurement, should be deflated and locked in
position when not in use
Thermistor: measures temp difference between the right atrium and the PA in order
to determine CO
What measure the preload of the right and left heart? - ANSWER -Right: CVP
Left: PAWP
What are manifestation for elevated CVP and PAWP? - ANSWER -Crackles in
lungs
JVD
Hepatomegaly
Peripheral edema
Taut skin turgor
, What are manifestations for decreased CVP and PAWP? - ANSWER -Poor skin
turgor
Dry mucous membranes
What is used to measure to afterload of the right and left heart? - ANSWER -
Right: pulmonary vascular resistance
Left: systemic vascular resistance
What are manifestations for elevated afterload? - ANSWER -Cool extremities
Weak peripheral pulses
What are manifestations for decreased afterload? - ANSWER -Warm extremities
Bounding peripheral pulse
What is another name for angiography? - ANSWER -Cardiac catheterization
PCI
Angiogram
What is angiography? - ANSWER -An invasive procedure used to evaluate the
degree and presence of coronary artery blockage. A renal, liver, cerebral, upper and
lower extremities angiogram can be done to determine blood flow and areas of
possible blockage of a vessel. It involves insertion of the catheter into femoral,
brachial, or radial vessel and threading into the right or left side of the heart
How can artery narrows and/or occlusions be identified in angiography? -
ANSWER -Injection of contrast media under fluoroscopy
What are indications for angiography? - ANSWER -Unstable angina and ECG
changes
Confirm and determine location and extent of heart disease
,What are postprocedure considerations for angiography? - ANSWER -Assess VS
Q15M x 4, Q30M x 2, Q1H x 1, then Q4H per facility protocol
Perform neurovascular checks at the same intervals as VS to assess for bleeding
and thrombosis (document pedal pulse, extremity color, and temp)
Bed rest in supine position, typically for 6-8 hrs, with extremity straight for
prescribed time
Continuous cardiac monitoring for dysrhythmias
Administer antiplatelet or thrombolytics as prescribed to prevent clots and
restenosis (Aspirin, Clopidogrel or Plavix, Heparin, Enoxaparin or Lovenox, GP
IIb/IIIa inhibitors such as eptifibatide)
Administer anxiolytics and analgesics PRN
Monitor urine output and give IVF for hydration
Perform/assist with sheath removal
Apply pressure to arterial/venous sites for prescribed time, apply pressure dressing
Observe for vagal response (hypotension, bradycardia)
What kind of meds will patients with stents receive with angigraphy? - ANSWER
-Anticoagulants
What are pre op considerations for a coronary artery bypass graft (CABG)? -
ANSWER -Is it elective or emergent?
Consent form
Confirm that recent chest x-ray, EKG, and labs are obtained
Baseline assessment
Assess client and family anxiety levels
, Educate on recovery expectations, which are endotracheal tube and mechanical
ventilation for airway management, inability to talk while endotracheal is in place,
early ambulation to prevent complications, hemodynamic monitoring devices, and
indwelling urinary cath
What are intra op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Median sternotomy incision is made to visualize heart and vessels
Client is placed on cardiopulmonary bypass, and the client's core temp can be
lowered to decrease the rate of metabolism and demand for oxygen
Cardioplegic solution is sued to stop the heart to prevent myocardial ischemia
Artery or vein is harvested and will be used as a graft
Pacemaker wire are sutured into the myocardium and chest tubes are placed
What are post op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Maintain patent airway and adequate ventilation
Continuous hemodynamic monitoring
Monitor VS and labs
Manage IV meds per protocol
Monitor chest tube patency and drainage, volume exceeding 150 mL/hr could be a
manifestation of hemorrhage
Pain management, splint, meds, enhance breathing
Infection prevention
Encourage mobility: get out of bed, use of incentive spirometer
What are complications of coronary artery bypass graft (CABG)? - ANSWER -
Pulmonary complications, such as atelectasis and PNA
Decreased CO
Verified 100% Correct
What is stress testing? - ANSWER -Client exercises the cardiac muscles by
walking on a treadmill
How is a pulmonary artery catheter instered? - ANSWER -Into a large vein
(internal jugular, femoral, subclavian, brachial) and threaded through the right atria
and ventricle into a branch of the PA
PA catheters have multiple lumens and components. What are they and what are
they used for? - ANSWER -Proximal Lumen: measures right atrial pressure
(central venous pressure or CVP), infuse IV fluids, and obtain venous blood
samples
Distal Lumen: Measures PAP (PA systolic, PA diastolic, mean PA pressure, and
PA wedge pressure), NOT USED FOR IV FLUIDS
Balloon Inflation Port: PAWP measurement, should be deflated and locked in
position when not in use
Thermistor: measures temp difference between the right atrium and the PA in order
to determine CO
What measure the preload of the right and left heart? - ANSWER -Right: CVP
Left: PAWP
What are manifestation for elevated CVP and PAWP? - ANSWER -Crackles in
lungs
JVD
Hepatomegaly
Peripheral edema
Taut skin turgor
, What are manifestations for decreased CVP and PAWP? - ANSWER -Poor skin
turgor
Dry mucous membranes
What is used to measure to afterload of the right and left heart? - ANSWER -
Right: pulmonary vascular resistance
Left: systemic vascular resistance
What are manifestations for elevated afterload? - ANSWER -Cool extremities
Weak peripheral pulses
What are manifestations for decreased afterload? - ANSWER -Warm extremities
Bounding peripheral pulse
What is another name for angiography? - ANSWER -Cardiac catheterization
PCI
Angiogram
What is angiography? - ANSWER -An invasive procedure used to evaluate the
degree and presence of coronary artery blockage. A renal, liver, cerebral, upper and
lower extremities angiogram can be done to determine blood flow and areas of
possible blockage of a vessel. It involves insertion of the catheter into femoral,
brachial, or radial vessel and threading into the right or left side of the heart
How can artery narrows and/or occlusions be identified in angiography? -
ANSWER -Injection of contrast media under fluoroscopy
What are indications for angiography? - ANSWER -Unstable angina and ECG
changes
Confirm and determine location and extent of heart disease
,What are postprocedure considerations for angiography? - ANSWER -Assess VS
Q15M x 4, Q30M x 2, Q1H x 1, then Q4H per facility protocol
Perform neurovascular checks at the same intervals as VS to assess for bleeding
and thrombosis (document pedal pulse, extremity color, and temp)
Bed rest in supine position, typically for 6-8 hrs, with extremity straight for
prescribed time
Continuous cardiac monitoring for dysrhythmias
Administer antiplatelet or thrombolytics as prescribed to prevent clots and
restenosis (Aspirin, Clopidogrel or Plavix, Heparin, Enoxaparin or Lovenox, GP
IIb/IIIa inhibitors such as eptifibatide)
Administer anxiolytics and analgesics PRN
Monitor urine output and give IVF for hydration
Perform/assist with sheath removal
Apply pressure to arterial/venous sites for prescribed time, apply pressure dressing
Observe for vagal response (hypotension, bradycardia)
What kind of meds will patients with stents receive with angigraphy? - ANSWER
-Anticoagulants
What are pre op considerations for a coronary artery bypass graft (CABG)? -
ANSWER -Is it elective or emergent?
Consent form
Confirm that recent chest x-ray, EKG, and labs are obtained
Baseline assessment
Assess client and family anxiety levels
, Educate on recovery expectations, which are endotracheal tube and mechanical
ventilation for airway management, inability to talk while endotracheal is in place,
early ambulation to prevent complications, hemodynamic monitoring devices, and
indwelling urinary cath
What are intra op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Median sternotomy incision is made to visualize heart and vessels
Client is placed on cardiopulmonary bypass, and the client's core temp can be
lowered to decrease the rate of metabolism and demand for oxygen
Cardioplegic solution is sued to stop the heart to prevent myocardial ischemia
Artery or vein is harvested and will be used as a graft
Pacemaker wire are sutured into the myocardium and chest tubes are placed
What are post op considerations for coronary artery bypass graft (CABG)? -
ANSWER -Maintain patent airway and adequate ventilation
Continuous hemodynamic monitoring
Monitor VS and labs
Manage IV meds per protocol
Monitor chest tube patency and drainage, volume exceeding 150 mL/hr could be a
manifestation of hemorrhage
Pain management, splint, meds, enhance breathing
Infection prevention
Encourage mobility: get out of bed, use of incentive spirometer
What are complications of coronary artery bypass graft (CABG)? - ANSWER -
Pulmonary complications, such as atelectasis and PNA
Decreased CO
