Page 112 - Critical Care Nursing Demystified

Chapter 3 CARE OF THE PATIENT WITH CRITICAL CARDIAC AND VASCULAR NEEDS 97

Collaborative Diagnostic and Laboratory Tools

2 There are a variety of diagnostic tools and laboratory results that can be used
in the care of a patient with cardiovascular disease. First we will look at diag-
nostic tools.

Diagnostic Tools

Arterial Blood Gases or ABGs
Respiratory issues such as pulmonary congestion can develop in individuals with
cardiovascular deficits, thereby compromising their health status. Arterial blood gas
analysis may be indicated to monitor levels of blood oxygenation. Refer to Chapter 2
for procedures and interpretation of arterial blood gas results. If the patient has an
intraarterial line usually placed in the radial or femoral arteries, arterial blood gas
samples can be obtained from these lines using sterile techniques.

Chest X-Ray
The chest x-ray is significant in determining the following: cardiac structure
and size, dilation of the main pulmonary artery, pulmonary congestion, pleu- Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
ral or cardiac effusion, the presence or position of pacemakers, intracardiac
lines, and pulmonary artery catheters. The chest x-ray is the oldest noninva-
sive method used to visualize heart images. The heart, aorta, and pulmonary
vessels are moderately dense structures that appear as gray areas on the
x-ray film.

EKG, ECG—Electrocardiogram
A noninvasive, 12-lead EKG is recommended and is always valuable in provid-
ing cardiac diagnostic information. Electrical conduction changes that occur
within the heart are recorded and monitored on rhythm strips. Diagnosis of an
acute MI can be seen with an ECG. Patients who have cardiac problems like
MIs will frequently have dysrhythmias. Rhythm strip analysis will be addressed
in Chapter 4, “Care of the Patient with Critical Cardiac Rhythm Disturbance
Needs.”

Echocardiograms
This is a noninvasive study that uses ultrasonic waveforms to obtain and display
images of cardiac structures, heart motion, and abnormalities such as aortic