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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Cardio

Concepts Covered:

  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Circulatory System
  • Cardiovascular Disorders
  • Terminology
  • Shock
  • Shock
  • Cardiovascular
  • Emergency Care of the Trauma Patient
  • Pregnancy Risks
  • Noninfectious Respiratory Disorder
  • Vascular Disorders
  • Immunological Disorders
  • Multisystem
  • Disorders of Pancreas
  • Neurological Emergencies
  • Respiratory Emergencies
  • Urinary System
  • Depressive Disorders
  • Medication Administration
  • Disorders of the Posterior Pituitary Gland
  • Adult

Study Plan Lessons

Atrial Fibrillation (A Fib)
Atrial Flutter
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Blood Flow Through The Heart
Blood Pressure (BP) Control
Brain Natriuretic Peptide (BNP) Lab Values
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Anatomy
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)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
Coronary Artery Disease Concept Map
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Digoxin (Lanoxin) Nursing Considerations
Disease Specific Medications
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Electrical Activity in the Heart
Electrical A&P of the Heart
Endocarditis Case Study (45 min)
Endocarditis for Certified Emergency Nursing (CEN)
Envenomation Emergencies for Certified Emergency Nursing (CEN)
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 Case Study (45 min)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Mixed (Cardiac) Heart Defects
Myocardial Infarction (MI) Case Study (45 min)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Stroke (CVA)
Nursing Care Plan for Coronary Artery Disease (CAD)
Obstructive Heart (Cardiac) Defects
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Performing Cardiac (Heart) Monitoring
Premature Ventricular Contraction (PVC)
Sinus Bradycardia
Sinus Tachycardia
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)
Stroke Therapeutic Management (CVA)
Supraventricular Tachycardia (SVT)
Sympatholytics (Alpha & Beta Blockers)
Stroke for Certified Emergency Nursing (CEN)
Stroke for Progressive Care Certified Nurse (PCCN)
TCAs
The Heart
Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)
Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Vasopressin
Ventilator Settings
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)
Advanced Cardiovascular Life Support (ACLS)