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level: Level 1 of Kern 1 tests

Questions and Answers List

level questions: Level 1 of Kern 1 tests

QuestionAnswer
airway assessments includehistory of snoring, dysmorphic facial features, rheumatoid arthritis, short neck, mouth or jaw irregularities
CABG meaningcoronary artery bypass graph
TEE definitiontransesophageal ultrasound
absolute contraindicationslack of staff/ equipment, no consent
relative contraindicationsfever, anemia, hypokalemia, pregnancy, electrolyte imbalance, GI bleed, renal failure, hypertension, uncooperative, arrhythmias, recent strokes
indication for cath suspecting coronary artery diseasenew-onset angina, unstable angina, evaluation before surgery, silent ischemia, + exercise intolerance test, atypical chest pain
indications for cath suspecting a MIunstable angina, failed thrombolysis, shock, mechanical heart complications
main indications for cathcoronary disease, MI, sudden cardiovascular death, valvular disease, congenital, aortography, EP studies, intervention, atrial closure device
major cath risksstroke, MI, arrhythmia, death
other cath risksaortic dissection, tamponade, congestive heart failure, contrast reaction, asystole, infection, thrombosis, embolus, vascular injury, vasovagal
how to gain informed consent?explain in simple terms risk and procedure, provide information, go over alternatives
in cath lab time out checkpatient ID, allergies, lab results, bp, pulses, anticoagulant status, access point
starting the procedure checkpaperwork, patient understanding, airways, IV lines, premedications, start documenting procedure
risks to staff and patientradiation, blood products, drugs, chemical solvents, lifting injury, falls
before draping the patient establish 2 thingsEKG lead and IV access
what is the 2 minute time out used for in procedures?allows time for nurses and technologist to catch up to the physicians orders and do them
ASA 2mild systemic disease that doesn't effect this (controlled diabetes)
what is the purpose of moderate sedation for these procedures?reduce patient discomfort, retains their airway, able to respond to stimuli
4 components to moderate sedationpreprocedural baseline assessment, drug dosage, monitoring, post-procedural monitoring
airway assessments includehistory of snoring, dysmorphic facial features, rheumatoid arthritis, short neck, mouth or jaw irregularities
right heart caths includeRA, RV, pulmonary valve, pulmonary arteries, tricuspid valve, pulmonary wedge, pressures and O2 sats
left heart caths includecoronaries, aorta, mitral valve, LA, LV, aortic valve, EP studies pressures and if right cath O2 sats
right heart pressures are mandatory forvalvular disease
left heart pressures are collected fornearly all studies
internal mammary artery angiographies are donefor patients that may need CABG procedures
elective procedures arescheduled
urgent procedures areneeded very soon
emergent procedures areneeded now
relative contraindication definitionstabilize and correct before procedure
absolute contraindication meansthe procedure will not happen
what puts patients at higher risk for procedures?acute MI, old, aortic aneurysm, aortic stenosis, congestive heart failure, diabetes, 3 vessel coronary disease, LV dysfunction, obesity, stroke, renal insufficiency, coronary stenosis, hypertension
stable angina definitionsymptoms when exercising
unstable angina definitionsymptoms at any time, sign of MI
thrombolysis definitiondissolving a blood clot with drugs
what do papillary muscles do?they hold the chordae tendineae, which holds the valve, loss of these can cause the valve to dismantle
sedation where the person is awake is called? (campbell will lose it if you call it something else)moderate sedation
ASA 1healthy maybe varicose veins
ASA 3severe systemic disease but not incapacitating (insulin dependant diabetes)
ASA 4not expected to live 24 hours with or without surgery (hemorrhage coma)