01.11 Cardiac Stress Test

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Included In This Lesson

Study Tools

Outline

Overview

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

Nursing Points

General

  1. Cardiac stress test
    1.  
    2. Electrocardiogram
      1. Electrodes on chest, legs, arms
      2. Monitors heart rate and rhythm
    3. Blood pressure
    4. Physical activity vs drug that mimic stress on heart
    5. 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

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!