Chapter 11 EKG

Providing safety

Whats the most important responsibility during an exercise EKG?

Congestive heart failure

What reason should a patient not do an exercise EKG?

Chemical stress test

What type of test would be performed if the patient is unable to stand or exercise?

Without the patient knowledge count the respiration rate and compare to the previous rate.

During the exercise EKG, your patient appears to be out of breath. After informing the physician of your suspicions, what do you do?

Check the chart or order.

Patient is on several medications, and is scheduled for a exercise EKG tomorrow, what should you do first to determine if the patient should take the medications?

Medication for hypertension

A beta blocker is?

12-lead ECG and blood pressure.

What is measured during an exercise EKG?

An underwire bra.

What SHOULD Not be worn during an exercise EKG?

3 hours

Patients should avoid caffeine, tobacco and alcohol _____hrs prior to exercise EKG.

Shortness of breath, weakness, dizziness or fatigue.

Patients should report signs and symptoms of______, _____,______&_______ during an exercise EKG.

2 hours

Patients should not take a hot bath or shower ______ hours after an exercise EKG.

The physician

Who will discuss the results of the EKG with the patient?

Comfortable clothes such as tennis shoes, and loose fitting pants.

What should the patient wear for an exercise EKG?

Yes

Should emergency equipment be available in the room or near by?

FALSE

True or false: should the leads be attached the same as an ambulatory monitor?

Chemical stress test

An exercise Electrocardiography that is invasive because of the injection of a radiopaque substance to view the vessels of the heart.

Myocardium

Middle layer of the heart, composed of muscle tissue.

Hypertension

High blood pressure

Beta blocker

Medications used to treat hypertension

Nuclear stress test

Stress test in which radioactive tracers are injected to trace the path of blood through the heart.

Angina

Pain around the heart caused by lack of oxygen to the heart.

Dysrhythmia

Loss of normal rhythm of the heart.

Cardiologists

A physician who specializes in the study of the heart.

Congestive heart failure

Failure of the heart to pump an adequate amount of blood to the tissue.

Coronary vascular disease

Accumulation of plaque and fatty deposits in the coronary arteries.

Echocardiograms

Noninvasive diagnostic test that uses ultrasound to study the heart and blood vessels.

False positive

A diagnostic test result that indicates that a disease is present when it really is not.

THR

Calculated by subtracting your age from 220

Bruce protocol

Is commonly utilized for a stress test

After each stage of an exercise ECG.

12 lead ECG and blood pressure is obtained

Assess the patient. Are they conscious? If unresponsive get the crash cart.

During an exercise EKG your patient complains of weakness and short of breath. Suddenly he/she collapses on the treadmill what do you do?

Explain the procedure takes longer than a hour. 1-4 hours maybe

Patient wants to have the exercise ECG during his/her lunch hr what would your response be?

Ischemia

On an ECG tracing S.T. depression may indicate?

S.T. depression

Certain medications like digitalis maycause

Helps diagnose chest pain, determines functional capacity of the heart after surgery or MI, screens for heart disease, helps set exercise limits, identifies causes of abnormal heart rhythms that develop during exercise, evaluates effectiveness of heart me

Uses for exercise electrocardiography

Supine, sitting, sitting post 30 second hyperventilation, standing

Obtain patient blood pressure and ECG in the following positions.

CHF, a change in resting ECG, recent MI or unstable Angina, uncontrolled hypertension, acute infection, significant emotional stress, severe aortic stenosis, aneurysm, thrombophlebitis and systemic or pulmonary embolism.

Health conditions that Prevents patient from having an exercise electrocardiography

Mild fatigue, perspiration, increased heart rate and increased respiratory rate.

Explain to the patient they may experience.

Taken while the patient is supine

First ECG

Taken while the patient is sitting

Second ECG

Patient is asked to breathe quickly and deeply, state of hyperventilation, for 30 seconds

Third ECG done to determine changes caused by breathing

Taken while patient is standing

Fourth ECG

Heart rate measurement needed to truly exercise the heart.

THR

THR, without symptoms or complications of dysrythmias

During the test the goal is to achieve

Rate pressure product, RPP.

Systolic blood pressure multiplied by the heart rate

RPP

Used to estimate oxygen utilization or myocardial work

Rest for several hours, avoid extreme temperature changes, do not use stimulants C.A.T. For 3 hours, don't take hot bath or shower for 2 hours, when to expect the results, and that the physician will discuss the results.

After exercise electrocardiography the patient should be given instructions to:

Caffeine, alcohol, tobacco

C.A.T.