DIAGNOSTIC TEST PURPOSE NORMAL RESULT NURSING RESPONSIBILITY
1. Electrocardiogram This test records the electrical Normal range 120 – 200 ms (3 Qualified nurses assess the
(ECG) activity of the heart, shows – 5 small squares patient by noting his pulse
abnormal rhythms on ECG paper). QRS duration rate, breathing difficulties if
(arrhythmias), and can (measured from first any, the chest pain if any, and
sometimes detect heart deflection of QRS complex to many other factors and
muscle damage. end of QRS complex at determine whether the heart
isoelectric line). Normal rhythm is stable or unstable.
range up to 120 ms (3 small
squares on ECG paper).
2. Stress test (also This test is done to monitor Normal blood flow during Instruct the patient to fast,
called treadmill or the heart while you walk on a exercise and restrict fluids (especially those
exercise ECG). treadmill or pedal a stationary rest. normal blood flow when containing caffeine), and
bike. Your doctor also resting but not during abstain from the use of
monitors your breathing and exercise, possibly indicating a tobacco products for 4 to 6 hr
blood pressure. A stress test blocked artery. low blood flow prior to the procedure.
may be used to detect when exercising and resting, Instruct the patient to
coronary artery disease, or to suggesting coronary artery withhold medications for 24 hr
determine safe levels of disease. before the test, as ordered by
exercise after a heart attack or the health-care provider
heart surgery. This test can (HCP).
also be done using special
medicines that stress the heart
in a similar manner as exercise
does.
3. Echocardiogram (also An echo is a noninvasive test Aortic annulus – 20-31mm Explanation of the procedure
known as echo) that uses sound waves to Sinus valsalva – 29-45mm to the patient, monitoring
evaluate your heart's Sinotubular junction – 22- during tranesophageal and
chambers and valves, as well 36mm stress examinations, and
as its pumping function. The Ascending aorta – 22-36mm establishing intravenous
echo sound waves create an access for sonicated saline,
image on the monitor as an microsphere contrast, and
ultrasound probe is passed medication administration.
across the skin over your
heart.
4. Transesophageal In this test, you will swallow a There are two normal heart Explanation of
echocardiogram (TEE) small probe, about the size of sounds, often described as a the procedure to the patient,
a little finger. The probe lub and a dub that occur in monitoring during
passes down the esophagus sequence with each heartbeat. tranesophageal and stress
nearer to the heart. It allows a These are the first heart examinations, and establishing
closer look at the heart's sound (S1) and second heart intravenous access for
structure and function. It also sound (S2), produced by the sonicated saline, microsphere
shows any abnormal tissue closing of the atrioventricular contrast, and medication
around your heart valves, if valves and semilunar valves, administration.
blood is leaking backward respectively.
through a valve, and if blood
clots are present in your heart
chambers.
5. Holter monitor For this test, you wear a small, Normal, meaning that you Advise the patient to wear
portable, battery-powered have no major changes in your loose-fitting clothing. Provide
ECG machine to record heart's rhythm. Abnormal, precautionary measures.
heartbeats over a period of 24 meaning that you have some Apply electropaste or
to 48 hours during normal type of irregular conductive paste to the skin
activities. At the end of the heart rhythm or problem with sites. Explain the importance
time period, you will return your heart's electrical system. of maintaining a diary to
the monitor to the doctor's record activities.
office so it can be read and
evaluated.
6. Cardiac For this test, your doctor Normal is defined here as no The nurse must thoroughly
catheterization (also guides a small catheter visible disease or luminal review the patient's case,
called coronary (hollow tube) through the irregularities (less than 50%) clinical history, presentation,
angiogram) large artery in your upper leg, as judged visually at and indication for the
or sometimes your wrist or coronary angiography. Normal procedure—working to ensure
arm, into your heart. Dye is angiography in patients with safe conditions for the
given through the catheter, chest pain is five times more patient's care.
and moving X-ray pictures are common in women than in
made as the dye travels men
through your heart. This
comprehensive test shows:
narrowing in the arteries,
heart chamber size, how well
your heart pumps, and how
well the valves open and close,
as well as a measurement of
the pressures within the heart
chambers and arteries.
7. Magnetic resonance This procedure uses a Reference ranges permit Provide patient with comfort
imaging (MRI) of the combination of large magnets, differentiation between measures as needed. Tell the
heart radiofrequencies, and a normal and pathological patient to resume his normal
computer to make detailed states. To date, this study is diet and activities unless
images of organs and the largest to provide CMR otherwise indicated. Monitor
structures in your body. Your specific reference ranges for vital signs. Monitor the patient
doctor may use MRI of the left ventricular, right for orthostatic hypotension.
heart to evaluate the heart ventricular, left atrial and right
valves and major vessels, atrial structure and function
detect coronary artery derived from truly healthy
disease, and the extent of Caucasian adults aged 45–74
damage it has caused,
evaluate congenital defects,
and detect the presence of
tumors or other abnormalities.
8. Cardiac CT scan This imaging procedure uses Results are Informed Consent. Obtain an
an X-ray machine and a considered normal if informed consent properly
computer to create a 3- the heart and arteries being signed. Look for allergies. Get
dimensional pictures of the examined are normal in health history. Check for NPO
heart. Sometimes a dye is appearance. Your "calcium status. Get dressed up.
injected into a vein so that score" is based on the amount Provide information about the
your heart arteries can be of calcium found in the contrast medium. Instruct the
seen as well. arteries of your heart. The test patient to remain still. Inform
is normal (negative) if your about the duration of the
calcium score is 0. procedure.
References:
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CAMERO, VERONICA IRA G.
BSN 3-1
