1. The client/caregiver can define an ambulatory electrocardiogram or a cardiac event recorder.
   1. It is a small, portable device that records the electrical activity of the heart for up to 24 hours.
   2. It is a continuous recording of heart rate and rhythm during normal activity, rest, and sleep.
2. The client/caregiver can describe the advantages of this method of a cardiac monitor.
   1. It can be used for the client that might have major health risks that contraindicate a stress electrocardiogram.
   2. It can help associate abnormal rhythms with the client’s complaint or symptoms.
   3. It also helps in the evaluation of a client’s progress in cardiac rehabilitation.
3. The client/caregiver can describe the procedure for a Holter monitor.
   1. Chest leads will be attached to the body and then connected to the monitor.
   2. The monitor is then attached to a belt or shoulder strap and will be worn for a specific amount of time.
   3. The client will be instructed to keep a log or diary, which will include
      1. Time and type of activity during testing
      2. Documentation if any medication was taken
      3. Documentation of any symptoms such as palpitations, chest pain, and dizziness.
   4. At the end of the test period, the monitor will be returned and the results plus diary entries will be evaluated.
   5. The client will return to the physician for a report and instructions.
4. The client/caregiver will list measures to aid in accurate test results using the Holter monitor.
   1. Avoid shower, tub bath, or swimming during testing.
   2. A sponge bath is allowed, but avoid getting the device wet.
   3. Avoid magnets, metal detectors, electric blankets, or high-voltage areas.
   4. Avoid oily or greasy skin creams or lotions where the self-sticking electrodes will be applied.
   5. Keep appointments with physicians for follow-up.
   6. Have list of telephone numbers to call, if having problems or questions with a test.
5. The client/caregiver can explain how to use an event monitor or event recorder.
   1. This device is worn for a longer period of time.
   2. It can be removed during showers or bathing.
   3. The electrodes are attached the same way to the chest and monitor.
   4. This device has a button to depress when having symptoms that will start recording the activity. It usually can store three events.
   5. This information can be sent immediately via the phone. If the results indicate an emergency situation, you will be instructed to call 911 or go to the emergency room.
6. The client/caregiver will list measures to aid accurate test results using an event monitor.
   1. Avoid magnets, metal detectors, electric blankets, or high-voltage areas.
   2. Avoid oily or greasy skin creams or lotions where the self-sticking electrodes will be applied.
   3. Keep appointments with physicians for follow-up.
   4. Have a list of telephone numbers to call, if having problems or questions with a test.

References

Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.
Lutz, C., & Przytulski, K. (2001).Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing . Philadelphia: Lippincott, Williams &
Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.