Diagnostic procedures associated with the Cardiovascular system, including: electrocardiography (EKG), echocardiogram, transesophageal echocardiogram (TEE), and hemodynamic monitoring. Coverage of a coronary angiogram (or “cardiac cath”), including pre-procedure and post-procedure nursing care.
Our Medical-Surgical video tutorial series is taught by Cathy Parkes BSN, RN, CWCN, PHN and intended to help RN and PN nursing students study for their nursing school exams, including the ATI, HESI and NCLEX.
0:00 What to Expect with Diagnostic Procedures \u0026 Coronary Angiogram 0:34 EKG 0:53 Echocardiogram 1:18 TEE 1:38 HemodynamicMonitoring 2:10 Coronary Angiogram 2:34 Nursing Care 4:55 Quiz Time!
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Content
0.48 -> I am Cathy with Level Up RN. In this video, I'm
going to wrap up our coverage of diagnostic tests
6.88 -> associated with the cardiovascular system. And
at the end of the video, I'm going to provide you
12.16 -> guys with a little quiz to test your knowledge of
some of the information I'll be covering in this
17.04 -> video. If you have our medical-surgical
nursing, second edition flashcards,
22.16 -> definitely pull those out so you can follow
along. Specifically, in this video, we will
26.8 -> be talking about procedures that we can use to
diagnose disorders of the cardiovascular system.
34 -> An EKG or electrocardiogram provides a graphic
representation of the heart's electrical activity.
42.48 -> And if you are needing help with EKG
interpretation, we have a great flashcard
48.4 -> deck and a complete video playlist to help you
with that. So definitely check that out if needed.
53.76 -> An echocardiogram uses ultrasound waves to help
visualize cardiac structures, especially the heart
61.36 -> valves. It also measures ejection fraction,
so normal left ventricular ejection fraction
69.04 -> is between 55 and 70 percent. So if your
patient has a reduced ejection fraction,
75.76 -> then that would be indicative of heart failure.
We also have a transesophageal echocardiogram,
83.28 -> so a TEE. This is where a transducer is placed
down the esophagus to provide a more detailed
91.44 -> view of those cardiac structures. And this
procedure is done under conscious sedation.
98.16 -> Hemodynamic monitoring provides direct measurement
of pressures in the heart and the great vessels
105.92 -> through an arterial line. So some of the pressures
that we can obtain through hemodynamic monitoring
112.64 -> include central venous pressure, which should
be between 2 and 6 mmHg. We can get the
119.68 -> pulmonary artery wedge pressure, which should be
between 4 and 12 mmHg, and we can also measure
127.44 -> cardiac output through hemodynamic monitoring.
Next, let's talk about a coronary angiogram or
133.84 -> what is referred to as a cardiac cat.
This is an invasive procedure that
139.04 -> is used to determine if your patient has a
blockage or narrowing of a coronary artery.
145.84 -> And during this procedure, a catheter is inserted
at the femoral artery and then threaded up to
153.04 -> the heart. So in terms of nursing care, we have
pre-procedure and post-procedure, nursing care.
160.32 -> Pre-procedure, we're going to want to make sure
our patient is NPO for eight hours or more. We're
166.88 -> going to want to assess for allergies to iodine
and shellfish. Although I have to be honest
172.72 -> with you, there's a lot of data and research to
indicate that an allergy to iodine or shellfish
179.68 -> does not increase an individual's risk for
having a reaction to the contrast dye associated
186.4 -> with a cardiac cath. However, most providers
still assess the patient for these allergies,
192.8 -> and as a nurse and a nursing student, this
is definitely important to know as well.
197.68 -> So you're going to assess for those allergies
to iodine and shellfish. You're also going to
202.4 -> assess your patient's kidney function. So you're
going to check their creatinine and BUN levels
208.56 -> because if the patient has impaired kidney
function, then they may not be able to excrete the
215.52 -> contrast dye easily, and that can be toxic to
the kidneys. In addition, we want to assess and
222.48 -> mark their distal pulses so that we can easily
find those after the procedure and check their
228.8 -> pulses. So you're going to mark that dorsal pitas
pulse and that posterior tibial pulse as well.
236 -> After the procedure, we're going to want to
check the insertion site at the femoral artery
241.6 -> for bleeding, and we're going to want to check
the extremity distal to that insertion site for
248.56 -> pulse, capillary refill, color, and temperature.
So we want to make sure we're getting good
253.84 -> blood flow down to that extremity. And then
we're going to closely monitor the patient's
258.8 -> vital signs per facility policy. So this often
includes taking vital signs every 15 minutes,
266.48 -> four times. So that first hour, you're going to
take it every 15 minutes and then after that,
272 -> you're going to take it every hour for four
hours. Again, your facility policy may vary,
278.56 -> but we will definitely be closely monitoring
their vital signs. And then we also want to
283.52 -> encourage our patient to increase their intake
of fluids to try to flush out that contrast dye.
289.52 -> And we're going to have our patient lay flat
for four to six hours after the procedure.
295.52 -> Okay, time for a quiz. I have three
questions for you. First question,
300.32 -> what procedure uses ultrasound waves to visualize
cardiac structures and measure ejection fraction?
310.88 -> If you said an echocardiogram,
you're correct. Question number two,
316.72 -> what lab values are used to assess a patient's
kidney function prior to a cardiac cath?
325.84 -> The answer is creatinine, as well as BUN.
Creatinine being the more important of those two.
333.52 -> Question number three, how should a
patient be positioned after a cardiac cath?
342 -> The answer is they need to lay flat, and
they need to lay flat for four to six
346.56 -> hours after the procedure. Okay, that's it
for this video. I hope it's been helpful.
352.72 -> If so, be sure to like this video. Leave me a
comment if there are other topics or suggestions
358.8 -> you have for me. I definitely want to hear
those. In my next video, we will start talking
363.76 -> about dysrhythmias, so definitely check that out.
I invite you to subscribe to our channel and share
369.84 -> a link with your classmates and friends in nursing
school. If you found value in this video, be sure
375.52 -> and hit the like button, and leave a comment and
let us know what you found particularly helpful.
