Question

Description:

John Miller, a 65-year-old male, arrives at the clinic complaining of his shoes not fitting and feeling like he cannot take a deep breath. During the patient interview, he also states that he is having intermittent pain in his chest. He is taking glyburide 2.5 mg daily, captopril 25 mg twice a day, and HCTZ 25 mg daily. He has not taken the HCTZ for 2 weeks and is hoping to get this medication refilled. The physician wants to evaluate his congestive heart failure. He orders an ECG and a stress echocardiogram. The patient has not previously had a stress echocardiogram and you need to explain it to him before the test begins.

Discussion Questions:

1. Explain to John the difference between an ECG and an echocardiogram.

2. John expresses concern about having a heart attack during the procedure. How can you alleviate his fear?

3. You must perform an ECG on this patient. Describe the steps in the procedure.

Please answer all 3 questions separately. Thanks

Answer 1

(1) both echocardiogram and EKG are very important and are commonly used for examine heart tests taht are instrumental in the diagnosing the various heart related problems . Thses both test are often used in the conjunction and are the complimentary to each other ,

THE DIFFERENCE BETWEEN ECG AND ECHOCARDIOGRAM.

ECG

ECHOCARDIOGRAM

The ECG is a heart tracing that mainly provides information on the rythm of the heart , The ECG is also known as EKG , a 12 lead or an electro cardiogram Basically every patient evaluated for a heart related issues or heart realted symptoms get an EKG , It can be done by 10 small sticky pads on various places on the chest wall then leads from EKG machine are attached , these leads transmit data that use the electrical activity of the heart to generate a tracing .

The echocardiogram is an ultrasound form of the heart that provide moving pictures and procvide information on the structures and functioning of the heart . Echocardiogram is also known as an ultrasound scan of the heart , an echo or sonar of the heart . The echocardiogram is also very common usd but not as much like the EKG . it can be done by giving a patient gown to wear and lie on atable specifically designed to perform the echocardiogram . patient will typically lie on their left hand side . ultrasound gel is applied to various areas of the chest wall then the ultrasound probe placed on the chest and the pictures .

(2) we have to explain the John very calmly that the these procedure didn't cause you any kind of heart attack , it just an the fear of it , that the john have to over come from it , we demonstrate to the john by visualizing the procedure on another one patient , so that his fear get reduced up to the certain limit , and establish the good rapport before the procedure so that his fear could go away , , as well as also telling him the importance of teh procedure that how helpful is it in diagnosis his disease problem , early the diagnosis, early the recovery from the disease  while performiong theprocedure we have to stay with him so that his belives on you will encourage ,

(3) A 12 lead of electrocardiography shows the electrical activity occuring in apatients's heart at the moment it is recorded .It is an essental skill to be able to perform and also able to interpret the ECG findings,

PROCEDURE OF STEPS

1. for performing this procedure we will firstly performing these steps;-

• Hand senitizer
• ECG machine
• 10 sticky pads for attaching the electrodes to
• occasionally needs wipes ans razor

2. wash the hands and introduce ourself to the John ( patient) and clarify their identity

3- then going to explain what we will going top perform and what to gain consent to proceed

4- Ensure the patient is in comfortable position , for this test the patient must have their top off so offer a chaperone

5- For the ECG pads to stick there must be good contact with the skin , therefore ensure there is nothing which could prevent this, forexample shave hair or wipe off any cream /lotion .

6- input the patient data into the machine correctly , thus ensuring the correct details are printed into the ECG

7_ although this is called a 12 lead ECG and we only need 10 sticky pads , a 4 for the limb leads and 6 for chest leads , then after place them in the following pattern ;-

• Right wrist ( or shoulder)
• Left wrist ( or shoulder )
• Right ankle , laterally
• Left ankle ( Laterally )
• V1 at the 4th intercostal space at right sternal edge
• V2 in the 4th intercostal space at left sternal edge
• V3 between V2 and V4
• V4 in 5 th intercosta;l space in the mid clavicular line .
• V5 horizontal to V4 in anterior axillray line .
• V6 horixzontal   to V4 and V 5 in mid axillary line .

then after attachthe leads to the pads .