Stress test

INTRODUCTION

Stress test is a non-invasive procedure to evaluate cardiovascular status of patient who is suffering from cardiac disease or at risk. This test increases the cardiac activity by increasing physical activity.

"A stress test, also known as an exercise test or treadmill test"

DEFINITION

Stress test is a method to evaluate cardiovascular response to the physical stress.

PURPOSES

  • To assess cardiac ability (function).
  • To assess people at risk.
  • To evaluate effectiveness of therapeutic treatment.
  • To rule out various cardiac disease conditions.

INDICATIONS

  • Coronary artery disease
  • Risk of coronary artery disease
  • Patient on digoxin therapy
  • Exercise induced arrhythmias

CONTRAINDICATIONS

  • Acute myocardial infarction
  • Uncontrolled systemic hypertension
  • Recent pulmonary embolism
  • Moderate to severe mitral or aortic valve stenosis
  • Untreated arrhythmias
  • Second and third degree AV block
  • Acute systemic illness

CNURSING CONSIDERATIONS

Prior Procedure

  • Explain the procedure to the patient and his relatives.
  • Instruct the patient not to eat, smoke and drink alcohol 3-4 hours before test.
  • Instruct patient to remove jewelry.
  • Assess pulse, blood pressure and oxygen saturation before test.
  • Ask to undress the patient up to waist. Provide hospital gown or shirt to patient.
  • Prepare the site with alcohol swabs. If the skin is hairy, shave the site.
  • Attach electrodes to the chest and connect to the stress test machine.

During Procedure

  • A stress echocardiogram is a test done to assess how well the heart works under stress. The stress can be triggered by either exercise on a treadmill or a medicine called dobutamine.
  • Provide safety and comfort to the patient.
  • During a nuclear stress test, the individual will exercise, a radioactive dye is injected and then images are taken to assess the heart health.
  • Keep emergency drugs and equipment ready nearby.

Aftercare and Documentation

  • Record the date, time and patient's response in nurse's notes.
  • Monitor for complications.
  • Advise plenty of fluids to rehydrate the patient.

Complications

  • Cardiac arrhythmias
  • Anaphylactic shock
  • Renal failure

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