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which of the following pacing methods requires the use of external pacing pads - correct answer transcutaneous when transfering a patient to the recovery area or back to their room, what should be the actions of the person who achieved hemostasis of the procedure site - correct answer go with the patient and physically show the receiving nurse the site to discuss hemo details what is an advantage to using a filter versus a balloon occlusion distal protection device - correct answer allows distal perfusion in an AP projection, which of the following structures is the most posterior - correct answer left atrium door to balloon time for STEMI should occur within how many minutes - correct answer 90 what type of angina usually occurs with activity and subsides with rest - correct answer stable what are the possible vascular access sites for a left femoral artery intervention - correct answer left/right radial artery, right femoral artery, and left/right popliteal artery which of the following are typical findings in patients with hypertrophic cardiomyopathy - correct answer decreased LV compliance and hyper dynamic LV function what methods are used to treat flow limiting disections - correct answer stent, angioplasty (perfusion balloon), and covered stent what can not used for clots or dissections - correct answer atherectomy
which of the following hemodynamic abnormalities would be observed with mitral stenosis - correct answer large "a" wave in the left atrium which of the following can be used to assure good stent apposition in PCI - correct answer intravascular ultrasound (IVUS) which vascular closure device has a suture that is self tightening - correct answer angioseal which atherectomy catheters shave and sand away plaque - correct answer orbital and directional which of the following conditions would invalidate Fick cardiac output results - correct answer atrial septal defect (ASD) what type of balloon catheter should be used to treat fibrotic plaque and neointimal hyperplasia - correct answer scoring which of the listed signs and symptoms may indicate a vasovagal response - correct answer nausea, bradycardia, hypotension, and pale skin what information is required prior to prepping a patient for the procedure - correct answer NPO status, patient allergies, patient identifiers and advanced directive when educating a patient about their hemostasis site after either a radial or femoral approach, which of the following points must be made - correct answer keep the bandage on the site for 24 hours, do not submerge the site in water for 48 hours, do not bend the affected area during your recovery bed rest, and no strenuous movement or heavy lifting for 24 hours eximer lasers are primarily used to treat which types of lesions - correct answer bifurcation, heavily calcified, and chronic total occlusions what procedural setups should be considered when preparing a patient for a pacemaker/ICD inplant - correct answer arms restrained, cautory grounding pad attachment to the patient, IV located in the arm on the same side as the implanted device
what lab test is used to validate the effects of protamine sulfate - correct answer PTT what is the primary therapeutic reason for using rotational atherectomy as an adjunctive therapy for PCI
- correct answer to remove calcofic atherosclerotic plaque in determining cardiac output via the thermal dilution method, saline is injected into the _____________ port of the PA catheter - correct answer proximal which if the following medications inhibits sodium reabsorption causing an increase in urine output - correct answer lasix which of the following could increase the amount of hold time necessary for femoral artery hemostasis - correct answer aortic insufficiency the electrical current that determines the number of photons generated by an x-ray tube is called the - correct answer kilovoltage what emergency equipment should be accessible during a cardiac catheterization procedure - correct answer code cart, suction set up, airway equipment, and defibrillator/transcutaneous pacer in peripheral interventions, which equipment is used to steer across a lesion - correct answer balloon, guidewire, torque device, and microcatheter the patient has a pulse but is in respiratory arrest. you must give 1 breath every ___ seconds - correct answer 5- what vascular access sites can most commonly be used to perform a right ventricular biopsy - correct answer right internal jugular vein, left or right femoral veins, and left subclavian vein what complications are most frequently associated with vascular closure devices - correct answer infection, thrombosis, and delayed bleeding
which of the following is the most commonly used drug for sedation during a cardiovascular catheterization - correct answer midazolam which of the following Is responsible for producing the S2 heart sound - correct answer closure of the semi lunar valves the term "standard precautions" refers to - correct answer personal protective equipment where is the wire normalized when performing FFR - correct answer advanced outside the guide catheter when intervening in the mid/distal right leg from a radial approach, which is the best wire choice - correct answer .035x260cm what french size is equal to a 1.5mm rotational atherectomy burr - correct answer 4. which if the following catheters is primarily used for right heart procedures - correct answer German (balloon with side holes) which of the following is a GP IIb/IIIa inhibitor - correct answer abciximab (Reopro) activated clotting time (ACT) is used to assess the effects of which medication - correct answer heparin what type of imaging is most commonly used during PFO closures - correct answer ICE (intra-cardiac echo) which of the following cardiac pacemaker adjustments would change the unit from demand mode to the asynchronous mode - correct answer increase output voltage which of the following inotropic agents predominantly stimulates beta 1 receptors - correct answer dobutamine
what type of catheter is used for a thrombectomy - correct answer extraction which of the following types of devices are used to breakdown a blood clot - correct answer balloon angioplasty, angiojet, and thrombolyyic infusion equalization of aortic and arterial pressures is associated with which procedural device - correct answer FFR what type of valvuloplasty requires transeptal puncture - correct answer mitral Pseudoaneurysm - correct answer pulsatile hematoma that results from leakage of blood into soft tissues abutting the punctured artery with fibrous encapsulation and failure of the vessel wall to heal. (false aneurysm) mitral clip - correct answer requires antigrade approach afterload is most impacted by - correct answer aortic valve stenosis or aortic insufficiency in aortic stenosis understand how systolic and diastolic components of LV and AO are changed - correct answer when vascular pressure exceeds aortic pressure at the start of ventricular systole, the AV leaflets open to permit flow through the valve. CO increases until peak systole, beyond which it starts to decrease. tranaortic pressure gradient (^p) and flow rate through the valve vary with the time point in the cardiac cycle Why do we zero the transducer? - correct answer if not zeroed, it reads diastolic blood pressure. zeroing exposes the transducer to atmospheric pressure via an open air fluid interference and leveling assigns this zero reference point to a specific position on the symbolic fluid filled column that is the patients body. level at phlebostatic axis! what happens if the transducer level is high or low - correct answer for every 10 cm below the phlebostatic axis, the art line will add 7.4 mmHg of pressure.
what patient allergy should be considered to use rotaglide for the diamondback - correct answer lubricant equipment for RCA intervention - correct answer JL4 guide cath, balloon-stent cath, coronary guide wire, inflator mitral regurgitation indicated by v waves - correct answer when examining left atrial or PCWP pressure tracing, the v wave is accentuated in severe mitral regurgitation (tall v wave) FFR waveform - correct answer fractional flow reserve, insert pressure wire across a stenosis. adenosine given before measuring FFR. pullback to make sure no signal drift. AO pressure waveform on top (may be red) coronary pressure (may be green) on bottom (distal pressure) measure pressure differences across a coronary artery stenosis. FFR 0.80 or less you would usually do work Allen's test procedure - correct answer palm up, make fist, depress both ulnar and radial arteries, left off ulnar artery to check circulation, then reapply pressure and let off radial artery. 5- 15 second ms for blood return is good circulation. If no blood return- occluded artery Seldinger technique - correct answer desired vessel is punctured with hollow beveled needle, soft curved tip guidewire is inserted into the needle and advanced into the lumen, guidewire is held secure in place and the needle is removed, sheath is passed over the guidewire into the lumen, giudewire is withdrawn along with introducer leaving the sheath in place four crossing techniques for CTO (chronic total occlusion) PCI - correct answer antegrade, dissection and reentry, retrograde, and hybrid Impella - correct answer inlet located within the LV and outlet located within the ascending aorta mitrovalvuloplasty equipment - correct answer inoue balloon, and catheter orthopnea - correct answer difficulty breathing when lying down ASD closure uses what type of access - correct answer transeptal
anticoagulant - correct answer slows coagulation and prevents new clots from forming. heparin, warfarin (Coumadin), rivaroxaban (Xarelto), dabigatran (Pradaxa), apixaban (Eliquis), edoxaban (Savaysa), enoxaparin (Lovenox) a fogarty balloon is commonly used to - correct answer pull clot back into a vein which of the following best describes a balloons ability to yield to changes in pressure - correct answer compliance __________ exposes an operator standing on the right side of the patient to the highest dose of radiation - correct answer LAO cranial a 1.66mm diameter sheath is equivalent to what French size - correct answer 5 which if the following is associated with in-stent restenosis - correct answer poor stent apposition which of the following should be considered for radial artery spasm during sheath removal - correct answer analgesia, sedation, 200mcg NTG IA injection what vascular approach should be used to perform a transeptal left heart catheterization - correct answer right femoral vein cardiac index is calculated by dividing cardiac output in liters per minute by - correct answer body surface area (CI=CO÷BSA) which actions should be completed when prepping the patient for a transradial cardiac catheterization - correct answer prep right groin and Allen's test performed prior to wrist prep what blood chemistry would be used to determine the amount of contrast used in an angiographic procedure - correct answer creatinine
which medications are used to pre-treat a patient with a history of contrast allergies - correct answer famotidine (pepside: anti-histamine), diphenhydramine (benadryl), and solu-medrol what does contraindication for the use of rotational atherectomy include - correct answer saphenous vein graft, existing dissection, and angiographic evidence of thrombus the device that converts x-ray into visible light is the - correct answer image intensifier which of the following is a primary indication for the administration of sodium bicarbonate - correct answer metabolic acidosis (renal;stomach) which of the following represents the greatest risk during left ventriculography - correct answer air or thrombus embolism a ventricular gallop is associated with which heart sound - correct answer S the cephalic vein is located - correct answer in the anatomical area, on the outside of the arm positioning the image intensifier as close to the patient as possible - correct answer decreases scatter which of the following hemodynamic pressures would be used to check for mitral stenosis - correct answer if a patient had a large s-wave in lead VI and a. large R-wave in VS, you might suspect - correct answer anterior infarction mynx - correct answer PEG hydrogel plug Perclose - correct answer suture mediated angioseal - correct answer suture mediated and collagen
Anaphylaxis symptoms - correct answer difficulty breathing, itching, wheezing, anxiety, light-headedness, swelling, shock, faint (severe extreme allergic reaction) main cause of renal artery stenosis - correct answer atherosclerosis primary curve - correct answer engages the coronary ostium (RCA or left main) secondary curve - correct answer stabilizes the catheter along the opposite wall of the aorta order of femoral anatomy - correct answer nerve, artery, then vein EVAR (endovascular aneurysm repair) - correct answer repairs AAA's complications: endoleak, paraplegia, and mesenteric ischemia Endoleak - correct answer causes continued pressurization of the aneurysm sac and may leave the patient at risk for AAA repair. defined as a persistent blood flow outside the lumen of the endoluminal graft, within an aneurysm sac or vascular segment being treated by the device what drugs can be given post PCI - correct answer aspirin(ASA), Brilinta(ticagrelor), Plavix(clopidogrel) supine - correct answer lying face up prone - correct answer lying face down Fowler's - correct answer semi-sitting body position in which a person's head and shoulders are elevated 45 to 60 degrees Trendelenburg - correct answer head lower than feet
Reverse Trendelenburg - correct answer -entire bed is tilted with the foot of the bed lower than the head -position promotes gastric emptying and prevents esophageal reflux retroperitoneal bleed - correct answer Blood enters the retroperitoneal cavity through a small hole in the vessel. signs include severe back and groin pain, bruising over abdomin Hematoma - correct answer a solid swelling of clotted blood within the tissues.
