Term
| State the contraindications to the femoral approach. |
|
Definition
-Patients with peripheral vascular disease (femoral bruits or diminished lower extremity pulses)
-Abdominal aortic aneurysm
-Marked iliac tortuosity
-Prior femoral arterial graft surgery
-Gross obesity |
|
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Term
| State the indications and contraindications to the brachial approach. |
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Definition
Access may be indicated for patients with:
-Severe peripheral vascular disease, making upper extremity vascular access preferable
-Urgent or emergent cardiac catheterization with an increased risk of bleeding (owing to chronic oral anticoagulation or recent thrombolytic therapy)
-A need for early ambulation or mobility (outpatient procedures, severe back pain, and so on).
Relative contraindications to access are:
-Absence of a brachial pulse
-Presence of an arteriovenous fistula
-Overlying soft tissue infection
-Severe ipsilateral axillary or subclavian vascular disease
-Inability to extend the arm at the elbow or supinate the hand
Should not be used by an inexperienced operator unless backed up by a vascular surgeon or a cardiologist with expertise in this technique. |
|
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Term
| List the factors influencing the choice of approach in the cath lab. |
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Definition
-Patient issues (aortic occlusion, morbid obesity)
-Procedural issues (need for use of larger bore catheters)
-Patient/operator preference |
|
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Term
| Select the side effects of contrast agents. |
|
Definition
Older high-osmolar contrast agent had a number of potentially deleterious effects during coronary injection that include the following:
-Transient (10 to 20 second) hemodynamic depression marked by arterial hypotension and elevation of the left ventricular end diastolic pressure
-Electrocardiographic effects with T-wave inversion or peaking in the inferior leads (during right and left coronary injection, respectively), sinus slowing or arrest, and prolongation of the PR, QRS, and QT intervals
-Significant arrhythmia (asystole or ventricular tachycardia/fibrillation)
-Myocardial ischemia owing to interruption of oxygen delivery or inappropriate arteriolar vasodilatation (coronary “steal”)
-Allergic reaction
-Cumulative renal toxicity
Some (but not all) of these adverse effects are eliminated by use of a low-osmolar contrast agent, albeit at a modest increased expense.
-Marked arterial hypertension
-Renal insufficiency may develop |
|
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Term
| Name the most common local complication with using the brachial approach for catheterization. |
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Definition
|
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Term
| State the definition and methods of prevention for the formation of a hematoma, pseudoaneurysm, and arteriovenous fistula. |
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Definition
-Hematoma – a collection of blood within the soft tissues
Prevention – Accurate puncture and puncture site compression or closure technique to minimize hematoma formation are essential parts of good catheterization technique.
-Pseudoaneurysm – may develop if a hematoma remains in continuity with the arterial lumen (i.e., following dissolution of the clot plugging the arterial puncture site). Blood flowing in and out of the arterial puncture expands the hematoma cavity during systole and allows it to decompress back into the arterial lumen in diastole.
Prevention – accurate puncture of the common femoral artery and effective initial control of bleeding after sheath removal.
-Arteriovenous fistula – results from ongoing bleeding from the femoral arterial puncture site that decompresses into an adjacent venous puncture site.
Prevention – most common findings at surgery are a low puncture (i.e., of the superficial femoral or profunda, transecting a small venous branch), emphasizing the importance of careful puncture technique in avoiding this femoral vascular complication. |
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Term
| State the most common complication after cardiac catheterization by the femoral approach. |
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Definition
| Although thrombotic complications do occur, poorly controlled bleeding from the arterial puncture site is a more common problem after cardiac catheterization by the femoral approach |
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Term
| Cite the mechanism of a vasovagal reaction. |
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Definition
-triggered by pain and anxiety, particularly in the setting of hypovolemia.
-Inappropriate systemic arteriolar vasodilation. |
|
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Term
| State what patients should not receive protamine sulfate. |
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Definition
| insulin-dependent diabetics who have received NPH insulin |
|
|
Term
| State four materials that cardiac catheterization may precipitate allergic reactions. |
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Definition
-Local anesthetic
-Iodinated contrast agent
-Protamine sulfate
-Heparin (heparin-induced thrombocytopenia) |
|
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Term
| State the catheters used for right heart catheterization. |
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Definition
-Cournand catheter
-Lehman catheter
-Goodale-Lubin catheter
-Balloon flotation catheter
-Gensini catheter
-National Institutes of Health catheter (NIH)
-Eppendorf catheter (USCI)
-Grollman pigtail catheter
-Berman angiographic catheter
-Double lumen catheter
-Multilumen catheter |
|
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Term
| State the catheters used for right-sided ventriculography. |
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Definition
-National institutes of Health catheter (NIH)
-Eppendorf catheter
-Grollman pigtail catheter |
|
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Term
| Discuss the J-loop technique when performing a right heart catheterization with a balloon tipped catheter when approaching from both the SVC and the IVC. |
|
Definition
IVC:
-If the right atrium is enlarged, greater curvature of the catheter may be necessary, i.e., a large J loop.
-Such a loop may be formed by bending the tip of the catheter against the lateral right atrial wall or by engaging in the ostium of the hepatic vein (just below the diaphragm).
-Rotate clockwise in the atrium causing the tip of the catheter to enter the right ventricle.
-Withdraw catheter slightly so that its tip lies horizontally and just to the right (patient’s left) of the spine. Rotate clockwise to cause catheter tip to point upward (and slightly posteriorly) in the direction of the RVOT.
-Advance catheter through RVOT into PA. (May be facilitated by having the patient take a deep breath).
SVC:
-The catheter is advanced so that its tip catches on the lateral right atrial wall and forms the letter J.
-Rotate counterclockwise so that the catheter tip sweeps the anterior right atrial wall (thus avoiding the coronary sinus) and jumps across the tricuspid valve into the right ventricle.
-The catheter tip, pointing toward the RVOT, can be easily advanced into the PA.
-The patient takes a deep breath, and the catheter is advanced to the “wedge” position. |
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Term
| Choose the anatomical landmarks used in the selection of a puncture site for catheterization (femoral) |
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Definition
| -1 or 2 cm below the inguinal ligament (which runs from the anterior superior iliac spine to the pubic tubercle) -fluoroscopy should show skin nick overlie the inferior border of the femoral head. Skin nicks at this level increases the chance that the needle puncture will take place in the common femoral segment (overlying the middle of the femoral head) rather than too high. -The femoral artery should be easily palpable over a several-centimeter span above and below the skin nick site. -The femoral vein will lie approximately one fingerbreadth medial to the artery along a parallel course. |
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Term
| Select the reasons for performing a transseptal left heart catheterization. |
|
Definition
Situation in which:
-direct left atrial pressure recording was desired (pulmonary venous disease)
-it was important to distinguish true idiopathic hypertrophic subaortic stenosis (IHSS) from catheter entrapment
-Retrograde left-sided heart catheterization had failed (e.g., owing to severe peripheral arterial disease or aortic stenosis)
-Dangerous owing to the presence of a certain type of mechanical prosthetic valve (e.g., Bjork-Shiley or St. Jude valves).
-Percutaneous mitral valvuloplasty and antegrade aortic valvuloplasty using the Inoue balloon. |
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Term
| Choose the basic features and construction of a balloon-tipped flow-directed catheter. |
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Definition
•Made of PVC
•Soft pliable shaft
•Balloon located 1- 2 mm from tip and sticks out past the end of the catheter to prevent damage to the endocardium.
•110 cm long and color coded for sheath size.
•Requires ½ French size larger sheath.
•Heparin coated for prolonged insertion.
•3 or 4 lumen catheter for RA, PA, PCW pressure and medication port.
•Proximal port 20 – 30 cm from tip
•Radiopaque
The inflated balloon protrudes slightly beyond the tip of the catheter, trauma to the endocardium is prevented. |
|
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Term
| State which two areas are used to draw oxygen saturations in order to determine if there is a possible left-to-right shunt. |
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Definition
|
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Term
| Select the oxygen percent step-up used to determine if there is a left-to-right shunt. |
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Definition
| If the difference in saturations between the SVC and PS samples is > or = to 8%, a left-to-right shunt may be present at atrial, ventricular, or great vessel level, and a full oximetry run should be done. |
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Term
| Select the percentage of patients that have a right-dominant, left-dominant, and co-dominant coronary artery circulation. |
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Definition
-Right-dominant = 85%
-Left-dominant = 8%
-Co-dominant = 7% |
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Term
| Select the criteria used to determine if a patient has a right-dominant, left-dominant, or co-dominant/balanced coronary artery circulation. |
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Definition
-Right-dominant the RCA goes on to form the AV nodal artery, the posterior descending and the posterolateral left ventricular branches that supply the inferior aspect of the interventricular septum.
-Left-dominant the posterolateral left ventricular, posterior descending, and AV nodal arteries are all supplied by the terminal portion of the left circumflex coronary artery.
-Co-dominant the RCA gives rise to the posterior descending artery and then terminates, and the circumflex artery gives rise to all of the posterior left ventricular branches and perhaps also a parallel posterior descending branch that supplies part of the interventricular septum. |
|
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Term
| List the mistakes that may lead to an incomplete, uninterpretable or misinterpreted study. |
|
Definition
-Inadequate number of projections
-Inadequate injection of contrast material
-Superselective injection
-Catheter-induced coronary spasm
-Congenital variants of coronary origin and distribution
-Myocardial bridges
-Total occlusion |
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Term
| Choose the optimal location for the catheter while performing left ventriculography. |
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Definition
-The optimal catheter position is the midcavity, provided that ventricular ectopy is not a problem.
-If midcavity position induces repetitive ventricular ectopy the tip of the catheter is best repositioned so that it lies in the LVOT immediately in front of the posterior leaflet of the mitral valve. |
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Term
| Select the complications of cardiac ventriculography. |
|
Definition
-Arrhythmias
-Intramyocardial injection (endocardial staining)
-Fascicular block
-Embolism
-Increased heart rate
-Depressed LV contraction
-Transient nausea and vomiting |
|
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Term
| Choose the anatomical features that should be located when trying to gain access into the right internal jugular vein. |
|
Definition
-With the patients head rotated to the left, the sternal notch, clavicle, as well as the sternal and clavicular heads of the sternocleidomastoid muscle are identified.
-A skin nick is made between the two heads of this muscle, and two fingerbreadths above the top of the clavicle (near the top of the anterior triangle). |
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Term
| State the main hazard of endomyocardial biopsy, as well as the steps that should be taken in order to detect for it. |
|
Definition
Ventricular Perforation
*need more info |
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Term
| Match the mode or function for the intersociety commission for heart disease resources five-position code for pacemakers. |
|
Definition
Chamber Paced (I):
-V, Ventricle
-A, Atrium
-D, Atrium & Ventricle
Chamber Sensed (II):
-V, Ventricle
-A, Atrium
-D, Atrium & Ventricle
-O, None
Mode of Response (III):
-I, Inhibited (output blocked by sensed signal)
-T, Triggered (output elicited by a sensed signal)
-D, Atrial triggered & ventricular inhibited
-O, None
Programmability (IV):
-P, Programmable rate and or output
-M, Multiprogrammability (mode, AV delay, refractory period, sensitivity, hysteresis, etc.)
-C, Communicating, telemetric functions
-R, Rate Modulation
-O, None
Antitachyarrhythmia functions (V):
-B, Burst of impulses
-N, Normal-rate competition (i.e., dual-demand pacemaker)
-S, Scanning (i.e., timed extrasystoles)
-E, External control (activated by magnet, radio, or other). |
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Term
| Choose the contraindications for intra-aortic balloon counterpulsation. |
|
Definition
-Significant aortic regurgitation.
-Abdominal aortic aneurysm.
-Aortic dissection.
-Uncontrolled septicemia.
-Uncontrolled bleeding diathesis.
-Severe bilateral peripheral vascular disease uncorrectable by peripheral angioplasty or cross-femoral surgery.
-Bilateral femoral-popliteal bypass grafts for severe peripheral vascular disease. |
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Term
| Select the correct reason why intra-aortic balloon counterpulsation timing is adjusted when the console is set at 1:2 pumping. |
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Definition
| -So that arterial pressure tracings from consecutive beats with and without counterpulsation can be compared. |
|
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Term
| Name the correct part of the central aortic wave form and the EKG waveform that is used to time the inflation and deflation of the intra-aortic balloon. |
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Definition
-IABP inflation should occur at the aortic dicrotic notch (T wave on ECG)
-IABP deflation should occur immediately before systole (at or before the R wave) to provide maximal diastolic flow and maximal reduction of “presystolic” pressure. |
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Term
| Select the characteristics of cardiac tamponade. |
|
Definition
-Compress the underlying cardiac chambers
-Creates ventricular interdependence whereby changes in pressure and volume in one ventricle thus produce changes in diastolic filling, contraction, and relaxation in the other ventricle.
-Jugular vein distention
-Pulsus paradoxus
-Hemodynamically, the diagnosis of tamponade is made if there is identical elevation of left and right-sided diastolic pressures with loss of the y descent in a patient with pericardial effusion. |
|
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Term
| Select the advantages of endotracheal intubation. |
|
Definition
-Keeps the airway patent
-Ensures delivery of a high concentration of oxygen
-Ensures delivery of a selected tidal volume (10 to 15 mL/kg) to maintain adequate lung inflation
-Isolates and protects the airway from aspiration of stomach contents or other substances in the mouth, throat, or upper airway
-Permits effective suctioning of the trachea
-Provides a route for administration of several medications |
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Term
| Choose the possible complications associated with hyperventilation. |
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Definition
| Hyperventilation (too many breaths per minute or too large a volume per breath) can be harmful because it increases intrathoracic pressure, decreases venous return to the heart, and diminishes cardiac output. It may also increase gastric inflation and predispose the patient to vomiting and aspiration of gastric contents. |
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Term
| Define and identify/label hypokinesia, akinesia, and dyskinesia. |
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Definition
-Hypokinesia – a diminished, but not absent, motion of one part of the LV wall (also called weak or poor contraction).
-Akinesia – total lack of motion of a portion of the LV wall (i.e., no contraction).
-Dyskinesia – paradoxical systolic motion or expansion of one part of the LV wall (i.e., an abnormal outward bulging during systole.) |
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Term
| a coronary artery bypass graft, match that graft to its most common origin from the aortic wall. |
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Definition
-Grafts to the LCA arise from the left anterior surface of the aorta, with grafts to the circumflex system usually placed somewhat higher on the aorta than those to the LAD or DIAG branches.
-Grafts to the RCA (or the distal portions of a dominant circumflex) usually originate from the right anterior surface of the aorta, above and somewhat behind the plane of the native right coronary ostium. |
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Term
| Define profile as it applies to coronary dilation catheters. |
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Definition
| The diameter of the smallest opening through which the deflated balloon can be passed. |
|
|
Term
| State the indications to cardiac catheterization and angiography. |
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Definition
Indications:
-To confirm the presence of a clinically suspected condition, define its anatomic and physiologic severity, and determine the presence or absence of associated conditions when a therapeutic intervention is planned in a symptomatic patient.
-Patient with an acute coronary ischemic syndrome (unstable angina or acute myocardial infarction) in whom an invasive therapeutic intervention is contemplated.
-Consideration of heart surgery
-Assessment of crucial determinants of prognosis, such as left ventricular function, status of the pulmonary vasculature, and the patency of the coronary arteries.
-Use optimize pharmacologic therapy for advanced CHF.
-Aid in the diagnosis of obscure or confusing problems
-Research procedure |
|
|
Term
| State the contraindications to cardiac catheterization and angiography. |
|
Definition
Contraindications:
-At present, the only absolute contraindication is refusal of a mentally competent patient to consent to the procedure.
-Uncontrolled ventricular irritability
-Uncorrected hypokalemia or digitalis toxicity
-Uncorrected hypertension
-Intercurrent febrile illness
-Decompensated heart failure
-Anticoagulated state
-Severe allergy to radiographic contrast agent
-Severe renal insufficiency and/or anuria |
|
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Term
| Choose the areas on a gown that are considered sterile once it has been put on by the operator. |
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Definition
-Gowns are sterile in the front, from waist to axillary line: the sleeves except the axillary area.
-Only portions easily observed are sterile
-Hands are kept in sight and above waist
-Hands and arms are never folded |
|
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Term
| Select the times when the catheterization lab should be cleaned. |
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Definition
-Before first case
-During each case
-After each case
-After last case |
|
|
Term
| State how microorganisms are removed. |
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Definition
| Removed with soap or detergent and water. |
|
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Term
| List the factors that may increase the chance of an infection developing. |
|
Definition
-Susceptibility of host
-Age (extreme youth or old age)
-Chronic disease
-Poor nutritional status
-Drugs
-Strength and number of pathogens |
|
|
Term
| List the indications for performing PTCA. |
|
Definition
-Angina pectoris causing sufficient symptoms despite optimal medical therapy
-Mild angina pectoris with objective evidence of ischemia (abnormal stress testing or physiology) and high-grade lesion (>70% diameter narrowing) of a vessel supplying a large area of myocardium
-Unstable angina
-Acute myocardial infarction (MI) as primary therapy or in patients who have persistent or recurrent ischemia after failed thrombolytic therapy
-Angina pectoris after coronary bypass graft surgery
-Restenosis after successful PCI |
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Term
| Choose the proper injection technique for performing high-quality coronary injections to include the complications associated with an injection that is too timid or too vigorous. |
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Definition
-High-quality coronary angiography requires selective injection of radiographic contrast at an adequate rate and volume to transiently replace the blood contained in the involved vessel with slight but continuous reflux into the aortic root
-Too timid an injection allows intermittent entry of nonopaque blood into the coronary artery (producing contrast dilution or streaming, which makes interpretation of lesions difficult) and fails to visualize the coronary ostium and proximal coronary branches.
-Too vigorous an injection may cause coronary dissection or excessive myocardial blushing, and too prolonged an injection may contribute to increased myocardial depression or bradycardia.
-Adjust the rate and duration of manual contrast injection to match the observed filling pattern of the particular vessel being injected. Injection velocity should be built up gradually during the first second until the injection rate is adequate to completely replace antegrade blood flow into the coronary ostium. The injection should be maintained until the entire vessel is opacified. |
|
|
Term
| Given an area of infarction, list the EKG leads used to determine if it is an anterior, inferior, lateral, or posterior infarction. |
|
Definition
-Anterior Infarction: V1, V2, V3, V4
-Inferior Infarction: II, III, AVF
-Lateral Infarction: I, AVL, V5, V6
-Posterior Infarction: V1, V2, V3 |
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Term
| State the reasons why the power injector operator should be careful when aspirating blood into the contrast syringe. |
|
Definition
The operator must be careful when aspirating blood into the contrast syringe for two reasons:
-A large blood volume in the syringe dilutes the contrast material.
-More important, but rarely, after some time the blood may clot in the injector syringe. |
|
|
Term
| State the reason why patients experience a hot flushing sensation during bolus injections of contrast media. |
|
Definition
| Caused by artery vasodilation. |
|
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Term
| Choose the characteristics of demand and fixed mode settings for temporary pacemakers. |
|
Definition
-Demand mode means that the pacemaker paces when the heart rate drops below the level set by the demand rate (e.g., demand set at 50 beats/min). This mode would be useful when a patient has a vasovagal reaction or heart block with a heart rate of 40 beats/min. Pacing would start when the pacer detected a rate of less than 50 beats/min; the sensitivity must be lowered to allow the detection of native complexes.
-Fixed rate mode means that the pacer works continuously at the rate set. |
|
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Term
| List and discuss the three types of angioplasty balloon types. |
|
Definition
-Over the Wire: has a central lumen throughout the length of the catheter for the guidewire and a separate lumen for the balloon inflation.
-Rapid Exchange (monorail): only a variable length of the shaft has two lumens. One lumen is for balloon inflation and the other, which extends through only a portion of the catheter shaft, houses the guidewire.
-Fixed wire: balloon mounted on the wire with a distal flexible steering tip. Fixed-wire balloons have only one enclosed lumen for balloon inflation. |
|
|
Term
| List the reasons behind choosing a contrast agent. |
|
Definition
-Cost
-Side effects
-Opacification |
|
|
Term
| State the normal amount of fluid contained in the unstretched pericardium as well as when the pericardial effusion becomes significant. |
|
Definition
-Normally contains 15 to 35 mL of serous pericardial fluid
-Significant pericardial effusion with even early signs of hemodynamic compromise is usually an indication for prompt drainage. |
|
|
Term
| Explain, in 100 words or less, the reasons for obtaining an echocardiogram before performing a pericardiocentesis. |
|
Definition
•Echo documents the presence, location, and size of effusion as well as reveal the extent to which the pericardial pressure is compromising cardiac function by showing diastolic collapse of the RV.
•The probability of success and safety of the pericardiocentesis is related to the size of the effusion because it has been shown that the procedure is likely to be uncomplicated if both anterior and posterior free spaces (>10mm) are present. |
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Term
| Describe the benefits of intraaortic balloon counterpulsation to include the hemodynamic effect, and the effects on oxygen demand from the heart |
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Definition
| -IABP counterpulsation increases diastolic pressure and coronary blood flow and decreases myocardial oxygen demand (i.e., reduces afterload). Balloon inflation in diastole (at the dicrotic notch on the central arterial pressure tracing) increases diastolic pressure, which increases coronary artery pressure and coronary flow. Deflation of the balloon just before systole (at end diastole, the upstroke of arterial pressure tracing) results in decreased ventricular afterload, which decreases myocardial oxygen consumptions and increases the cardiac output. |
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Term
| Describe the technique used to obtain hemostasis after the removal of a sheath from the femoral artery. Include the different amounts of pressure utilized to obtain hemostasis as well as the mechanisms employed to assure that a clot is not left in the artery. |
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Definition
| To remove the sheath, the operator places his or her left-hand fingers over the femoral artery. Because the actual puncture site is more cranial than the skin incision, the operator’s fingers should be places over the femoral artery above the skin puncture site. The operator applies gentle pressure and removes the sheath from the leg, taking care not to crush the sheath and “strip” clot into the distal artery. When a small spurt of blood purges the arterial site of retained thrombi, the operator should apply firm downward pressure. Manual pressure is heald firmly for 15 to 20 minutes (5 minutes of full pressure, 5 minutes of 75% pressure, 5 minutes of 50% pressure, and 5 minutes of 25% pressure). In patients receiving antiplatelet treatment (e.g., aspirin or clopidogrel), 20 to 30 minutes of puncture site compression may be necessary. During pressure application the pedal pulses are checked every 2 to 3 minutes. Diminished pulse is acceptable during brief full-pressure application, but the distal pulses should not be obliterated completely. |
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Term
| Choose the correct position of the IAB. |
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Definition
-The assembly is inserted through the sheath with the guidewire leading. The marker at the tip of the IABP catheter should be 1 to 2 cm below the top of the aortic arch. Remove guidewire.
-Fluoroscopic observation of the balloon inflation above the renal arteries confirms optimal placement. |
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Term
| Select the correct step in the procedures, care, and processing of instruments. |
|
Definition
•Hard water spots and scale – vinegar (pg 30)
•Use mildest effective cleaning procedure.
•Recommended cleaning tools- Cellulose sponges, fibrous brushes, cloth, stainless steel wool.
•Non-recommended cleaning tools: Ordinary steel wool, steel brushes, sharp objects, and hard objects.
•Rinse in running water (pg 30)
•Wipe dry to prevent spotting
•Manually wash soiled instruments: Put on disposable gloves; Open hinged instruments; Soak instruments in detergent water; scrub (wash) instruments; Rinse instruments; Terminally sterilize instruments |
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Term
| Given a list, select the advantages and disadvantages of different types of sterilizing agents. |
|
Definition
Ethylene Oxide:
Advantages
a) Easily attainable
b) Effective against all types of microorganisms
c) Non-corrosive and non-damaging
d) Effective penetratability
Disadvantages
a. Long exposure and aeration times
b. Expensive
c. Explosive and flammable
d. Toxic
Liquid Sterilizing Agents:
Advantages
a. Sporicidal, bactericidal, tuberculocidal
b. Can be used on cemented parts
c. Non-corrosive and won’t injure sharps
Disadvantages
a. Long exposure time – 10 hours
b. Caustic to tissue
c. Leaves residue
d. No shelf life |
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Term
| Given a step in the sterilization process, choose whether it is correct or incorrect. |
|
Definition
Sterilization Process
1. Types of sterilizers
a. Wall model – 5 to 30 cu ft
b. Portable model – 1 to 4 cu ft
2. Factors influencing sterilization
a. Exposure time 3-7 hours
b. Concentration – SOP
c. Temperature – 120 – 140 degrees Fahrenheit
3. Changes in Factors
a. Concentration lowered – time increased
b. Temperature lowered – time increased
c. Humidity lowered – time increased
4. Sterilizing cycle
a. Set exposure and pressure gauges
b. Vacuum and humidity phase
c. Sterilization phase
d. Gas evacuation phase
e. Admission of filtered air to relieve vacuum
5. Aeration
a. Reason
b. Time
1. Mechanical – 8 to 12 hours
2. Room temperature – 7 days
•Instruments must be disassembled for cleaning |
|
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Term
| Given a characteristic of a guidewire, select the correct type of guidewire it corresponds to. |
|
Definition
• Exchange wire – Length 260-300 cm; for catheter removal and insertion.(pg 22)
• J-curve guidwires- particularly useful for passage through tortuous vessels.
• Straight guide wires – passage through linear configurations.(pg 20); Check both ends to ensure the flexible end is inserted. |
|
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Term
| Given an example of a characteristic of a catheter material, match the characteristic which corresponds with the type of material. |
|
Definition
• Teflon – Stiffest. i.e. Brockenbrough (pg 4)
• Polyurethane – Tensile property memory (pg 3)
• Dacron- very maneuverable and flexible, most covered with polyurethane coating
• Polyethylene- degree of stiffness between polyurethane and Teflon
• Polyvinylchloride- ideal for flow directed materials (supple and flexible) poor tensile properties (memory) |
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Term
| Given a cardiac catheter, select it’s use. |
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Definition
• Eppendorf – same as NIH
• Fogarty – peripheral vascular embolectomy
• Judkins – Used primarily for coronary artery injections |
|
|
Term
| Given a description of a type of sterilization agent, choose whether it is correct or incorrect. |
|
Definition
Physical:
a. Moist heat – most commonly used, most efficient
b. Dry heat – not often used
c. Electron beams and gamma rays
Chemical:
a. Ethylene Oxide – cemented parts, heat-moisture sensitive items.
b. Solution (Cidex) |
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Term
|
Definition
| a living body so small it cannot be seen with the naked eye. |
|
|
Term
|
Definition
| a unicellular, plant-like microorganism, lacking chlorophyll. Bacteria are the major contributors to infection and disease. |
|
|
Term
|
Definition
| a protected, resting state which some but not all bacteria can enter in response to adverse environmental conditions. |
|
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Term
|
Definition
| a microorganism which can live and grow in the presence of oxygen. |
|
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Term
|
Definition
| A microorganism which thrives best or lives only without oxygen. |
|
|
Term
|
Definition
| a microorganism which prefers free oxygen but is also capable of growing in the absence of oxygen. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| a microorganism capable of producing disease: most pathogens are aerobic. |
|
|
Term
|
Definition
| the presence of pathogenic microorganisms in or on an object or person. |
|
|
Term
|
Definition
| an organism from which another organism or microorganism obtains its nourishment. |
|
|
Term
| Define Vehicles and Vectors |
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Definition
| the means of transportation of a microorganism from one host to another. Vehicles are inanimate objects; vectors are insects/rodents. |
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Term
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Definition
| the point at which something enters or leaves the body. |
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Term
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Definition
| the state or condition in which the body or a part of it is invaded by a pathogen which multiplies and produces effects which are injurious. |
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Term
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Definition
| the state of being resistant to injury. A condition of being able to resist a particular disease by preventing development of a pathogenic microorganism. |
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Term
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Definition
| free from all living microorganisms. |
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Term
| State the sources of infection in the CCL. |
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Definition
-Patient
-Staff
-Equipment used in wound
-Dust and droplets
-Visitors |
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Term
| Given a use and/or the description for a cardiac catheter, name the correct catheter. (Swan-Ganz, Cournand, Berman angiographic, Amplatz) |
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Definition
•Swan-Ganz – Used for RH Cath pressure recordings and TD CO.(pg 7-8)
•Pigtail – Open end with 4-12 side holes used for LV and AO grams.
•Cournand– Used in the absence of Swan-Ganz to obtain PCW. (pg 7)
•Berman angiographic- double lumen PVC with balloon for pulmonary angiography in adults or right and left heart cath in infants and small children. Not suitable for PCWP measurements(Page 12)
•Amplatz- can usually be selectively placed if placement of the Judkins catheter is unsuccessful. |
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Term
| State five basic design features of cardiac catheters that are important for successful catheterization. |
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Definition
-Material used
-Curve shape
-Flexibility
-Memory
-Catheter tip
-End and side holes
-Catheter hub |
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