A patient is having a cardiac evaluation to assess for possible heart failure and valvular disease. Which study best identifies heart function and measures the size of the cardiac chambers?
Electrophysiology study
12-lead electrocardiogram
Cardiac catheterization
Echocardiogram
The Correct Answer is D
Rationale:
A. An electrophysiology study assesses the electrical activity of the heart but does not evaluate heart function or chamber size.
B. A 12-lead electrocardiogram records the electrical activity of the heart but does not provide detailed information on heart function or chamber size.
C. Cardiac catheterization is an invasive procedure used to assess coronary artery disease and other structural heart conditions but is not the primary study for evaluating heart function and chamber size.
D. An echocardiogram is a non-invasive ultrasound that provides detailed images of the heart, including its function, chamber size, and valve function, making it the best choice for this purpose.
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Correct Answer is D
Explanation
Rationale:
A. Homocysteine is a marker for cardiovascular risk but is not used to monitor heart failure therapy.
B. LDL levels are associated with cholesterol management and do not directly reflect heart failure treatment effectiveness.
C. Troponin is a marker of myocardial injury, not heart failure severity.
D. B-type natriuretic peptide (BNP) levels correlate with the severity of heart failure and are used to monitor the effectiveness of heart failure therapy.
Correct Answer is C
Explanation
Rationale:
A. Passive range of motion may be performed, but it is not the priority in this situation.
B. The head of the bed should be elevated 30 degrees or less, not necessarily flat, to prevent complications.
C. Hourly urinary output measurement is essential because the intra-aortic balloon pump (IABP) can impair renal perfusion, and monitoring urine output helps assess renal function.
D. Anticoagulants are often necessary to prevent clot formation associated with the IABP, so avoiding them is not advised unless contraindicated.