General

Synonym/Acronym:
Echo, TEE.

Rationale
To assess and visualize cardiovascular structures toward diagnosing disorders such as tumors, congenital defects, valve disorders, chamber disorders, and bleeding.

Patient Preparation
There are no activity restrictions unless by medical direction. Instruct the patient that to reduce the risk of aspiration related to nausea and vomiting, solid food and milk or milk products are restricted for at least 6 hr, and clear liquids are restricted for at least 2 hr prior to general anesthesia, regional anesthesia, or sedation/analgesia (monitored anesthesia). The patient may be required to be NPO after midnight. The American Society of Anesthesiologists has fasting guidelines for risk levels according to patient status. More information can be located at www.asahq.org.

Regarding the patient’s risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken. Protocols may vary among facilities.

Patients on beta blockers before the surgical procedure should be instructed to take their medication as ordered during the perioperative period.

Normal Findings

• Normal appearance of the size, position, structure, movements of the heart valves and heart muscle walls, and chamber blood filling; no evidence of valvular stenosis or insufficiency, cardiac tumor, foreign bodies, or coronary artery disease (CAD). The established values for the measurement of heart activities obtained by the study may vary by health-care provider (HCP) and institution.

Critical Findings and Potential Interventions

• Aortic aneurysm
• Aortic dissection

Timely notification to the requesting HCP of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.