When to use exercise stress test

NSG 554 - Nurse Practitioners in Primary Care I

Exam 3

Question:

When to use exercise stress test

Answer:

NOT for detection of ischemia in asymptomatic patients with no hx revascularization.IS used to assess CAD in pts with c/p or DOE with intermediate risk of ACS ALSO shows patient's functional capacity which is a predictor of future cardiac events

Question:

exercise stress test + vs - results

Answer:

• if development of horizontal or downsloping ST depression of 1 mm
• if patient exercises to at least 85% of age predicted max hr without

evidence of inducible ischemia.

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Question:

meds that make exercise test less diagnostic

Answer:

BB, dig, ca channel blocker, antihtn. consult cardiology if these should be withheld before the test.

Question:

when to + nuclear or US imaging to exercise tolerance test

Answer:

LV hypertrophy with ST and T abnormalities on resting electrocardiography baseline ST and T wave abnormalities recent MI clinical use of digoxin Wolff parkinson white syndrome bundle branch block ventricular pacemaker

Question:

patient can't use treadmill how to perform stress test?

Answer:

pharmacologic stress test using coronary vasodilators--dipyridamole and adenosine and inotropic chronotropic drugs like dobutamine.this tests the coronary flow reserve. 2 / 4

reverse dipyridamole by aminophylline. reverse adenosine and dobutamine with stopping the infusion

Question:

Leading cause of death for women in US

Answer:

CAD.

more likely to have nonobstructive or single vessel disease which decreases the accuracy of stress testing.

Question:

Diagnostic testing for CVD in women

Answer:

SPECT limited d/t breast tissue.Risk stratification using gramingham risk score. don't stress test asymptomatic patients unless sedentary and wanting to begin aggressive exercise or if dbtc and PAD (high risk).

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Question:

Abdominal aortic aneurysm

Answer:

progressive permanent localized dilation of the abd. aorta with aortic diameter of 3 cm + or 50% inc in diameter compared wit adjacent normal segment.

Question:

aneurysms are defined by

Answer:

shape. true aneurysm involves all 3 layers.

fusiform: symmetric weakness that produces a bulge

saccular: asymmetric weakness or bleb on the side (trauma or wall defect)

pseudoadurysm--enlargement of only outer layer of vessel wall.

Size:

small <4 cm med 4-5.4 cm large >5.5 cm very large >6 cm

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