Cardiac Stress Test

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Included In This Lesson

Study Tools For Cardiac Stress Test

Heart Rhythms Signs and Symptoms (Cheatsheet)
Heart Rhythm Identification (Cheatsheet)
10 Common EKG Heart Rhythms (Cheatsheet)
Angina (Cheatsheet)
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Outline

Overview

  1. Cardiac stress test
    1. Heart function during physical activity
    2. EKG & blood pressure

Nursing Points

General

  1. Cardiac stress test
    1. Electrocardiogram
      1. Electrodes on chest, legs, arms
      2. Monitors heart rate and rhythm
    2. Blood pressure
    3. Physical activity vs drug that mimic stress on heart
    4. Echocardiogram may be used
      1. Symptomatic patients
      2. Abnormal resting EKG
      3. Pacemaker
      4. Previous abnormal stress test
  2. Indications
    1. Chest pain
    2. Irregular heart rate
    3. Irregular heart rhythm
  3. Purpose
    1. Assess coronary artery disease severity
    2. Increase myocardial demand
    3. Assess for ischemia

Assessment

  1. Before
    1. NPO midnight before
    2. No caffeine day before (interferes with results)
    3. Doctor may hold heart medications
    4. Explain test to patient

Therapeutic Management

  1. During
    1. Ensure life support nearby
      1. Risk of heart attack
    2. Place electrodes
    3. Place blood pressure cuff
    4. Radiologist tech will give medication (if indicated) OR physical activity
  2. After
    1. Doctor will interpret and provide results

Nursing Concepts

  1. Perfusion -> testing heart function (body perfusion)
  2. EKG Rhythms -> Electrocardiogram during test

Patient Education

  1. No caffeine day before test
  2. No food or drink after midnight the day before test

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Transcript

Hey guys! Welcome to the lesson on the cardiac stress test!

The cardiac stress test is done to show the heart function during physical activity using an electrocardiogram to monitor the rate and rhythm like on this strip, and blood pressure machine. The patient might exert themselves on a treadmill or bike. Often instead of actual physical activity, the patient might be given medication that mimics the stress on the heart that exercise would provide. This could be because the patient is unable to exert themselves physically. An echocardiogram may be used for symptomatic patients, patients with pacemakers, or patients  with abnormal EKG resting or during a previous stress test to get a better look at the heart during activity. Let’s talk about the purpose and why a patient might need a stress test. 

The cardiac stress test is ordered by the doctor to assess coronary artery disease severity, and assess for ischemia while the heart has an increased demand for blood flow. Ischemia is where there the blood flow is cut off, decreasing perfusion. A cardiac stress test might be indicated in the patient with chest pain or irregular heart rate or rhythms. Let’s explore what to do before the test. 

So when the doctor orders a stress test, you will notify your patient and explain the procedure to them. They will be kept NPO starting midnight before the test and will not be allowed caffeine the day before as they may interfere with the test results. The doctor may order to hold certain heart medications so look out for orders. 

During the test, make sure there is life support nearby because this test does put the patient at a small risk for a heart attack. Place the electrodes on their body  and wrap the blood pressure cuff onto their arm like in this picture. The radiology tech will give the medication unless the patient performs the physical exertion. After the test, the doctor will interpret and provide results to the patient. 

The priority nursing concepts for a patient with a cardiac stress test are perfusion and EKG rhythms. 

Alright guys, let’s review the key points. The cardiac stress test is done by exerting stress on the heart, either physical or pharmaceutical, along with an EKG and blood pressure. This is done to assess the heart function during stress. The cardiac stress test might be ordered if the patient has chest pain, or irregular heart rate or rhythms. Before the test, notify and explain it to the patient. They will be NPO and unable to have caffeine the day before the test. During, electrodes and a blood pressure cuff will be placed on the patient. Make sure that life support is nearby in case the heart stops. Let the patient know that the doctor will provide the results after they are interpreted. 

Okay guys, that’s it on the cardiac stress test! Now go out and be your best self today, and as always, happy nursing!

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CVOR

Concepts Covered:

  • Cardiac Disorders
  • Cardiovascular
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock
  • Shock
  • Adult
  • Medication Administration
  • Vascular Disorders
  • Newborn Complications
  • Noninfectious Respiratory Disorder
  • Eating Disorders
  • Intraoperative Nursing
  • Cardiovascular Disorders
  • Terminology
  • Pregnancy Risks
  • Urinary System
  • Upper GI Disorders
  • Studying
  • Disorders of Pancreas
  • Communication
  • Perioperative Nursing Roles
  • Substance Abuse Disorders
  • Acute & Chronic Renal Disorders
  • Pediatric
  • Respiratory Emergencies
  • Postoperative Nursing
  • Emergency Care of the Respiratory Patient
  • Neurological Emergencies
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.14 Shock Stages for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
ACE (angiotensin-converting enzyme) Inhibitors
ACLS (Advanced cardiac life support) Drugs
Acute Coronary Syndrome (ACS)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Adenosine (Adenocard) Nursing Considerations
Advanced Cardiovascular Life Support (ACLS)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Angiotensin Receptor Blockers
Arterial Pressure Monitoring
Aspiration for Certified Emergency Nursing (CEN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Blood Flow Through The Heart
Blood Pressure (BP) Control
Calcium Channel Blockers
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Cardiac (Heart) Enzymes
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Course Introduction
Cardiac Cycle
Cardiac Glycosides
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Stress Test
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Terminology
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
Coronary Artery Disease Concept Map
Digoxin (Lanoxin) Nursing Considerations
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Electrical A&P of the Heart
Electrical Activity in the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
Endocarditis for Certified Emergency Nursing (CEN)
Epinephrine (EpiPen) Nursing Considerations
General Anesthesia
GERD (Gastroesophageal Reflux Disease)
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hemodynamics
Hiatal Hernia
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Intraoperative Positioning
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
MI Surgical Intervention
Midazolam (Versed) Nursing Considerations
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Mixed (Cardiac) Heart Defects
Myocardial Infarction (MI) Case Study (45 min)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Obstructive Heart (Cardiac) Defects
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Pacemakers
Pediatric Advanced Life Support (PALS)
Performing Cardiac (Heart) Monitoring
Pericardial Tamponade for Certified Emergency Nursing (CEN)
Pleural Effusion for Certified Emergency Nursing (CEN)
Post-Anesthesia Recovery
Preload and Afterload
Premature Ventricular Contraction (PVC)
Product Evaluation and Selection for Certified Perioperative Nurse (CNOR)
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Sepsis Labs
Sinus Bradycardia
Sinus Tachycardia
Supraventricular Tachycardia (SVT)
The Heart
Thrombolytics
Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)
Troponin I (cTNL) Lab Values
Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Vasopressin
Ventilator Settings
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)