This document outlines various diagnostic and treatment services provided at a health and procedure center (HPC) including: electrocardiograms, ultrasounds, holter monitoring, stress tests, and hearing tests. It describes student nurse responsibilities like assisting with procedures, providing patient education and care, and maintaining equipment and facilities. Guidelines are provided for specific procedures and the equipment used.

3. SERVICES:
1) ElectroCardioGram (ECG)
2) ULTRASOUND: VASCULAR DUPLEX
(VENOUS/ARTERIAL, CAROTID, AVF,
RENAL ) & 2D ECHOCARDIOGRAM (TTE)
3) 24 HOUR HOLTER MONITORING
4) AMBULATORY BP MONITORING (ABPM)
5) TREADMILL STRESSTEST
6) AUDIOMETRY (ADULT) & NEWBORN
HEARING SCREENING

4. Student Nurses’ responsibilities
and duties:
Assists Nurses and Physician in
performing 2D Echo and Stress Testing.
Implements the nursing process in
providing nursing care before and after
the procedure.
Provides health education for patients
and family.
Assist and perform ECG

5. Documents all essential data of
patient/s.
Documents all normal and abnormal
findings
Monitors and maintains the unit
facilities and equipment.
Maintains cleanliness and orderliness of
the HPC Unit.

6. ECG GUIDELINES:
- ECG can only be performed by HPC
personnel, or trained and qualified
nurse.
- ECG can be performed as OP and IP
within the hospital premises.
- HPC staff performs ECG from 6am to
10 pm in the HPC unit (OP), IP and in
the emergency room.
- HPC personnel is responsible in filing
of all ECG strips.

7. ECG

8. ECG

10. ECG Official
Reading

11. SEIMENS
ACUSON
X300
GE VIVID
T8
2D Echocardiogram

12. SEIMENS
ACUSON
X300
GE VIVID
T8
VASCULAR DUPLEX SCAN
Arterial/Venous, Carotid, Renal, AVF

13. GUIDELINES FOR 2D ECHO/
VASCULAR
 The procedure should be scheduled with the
availability of the Px and the Doctor.
 This special procedure can be performed as OP
or IP. The procedure can be performed by the
Cardiologist/HPC nurse Cardiovascular
sonographer.
 Official results will encoded by the nurse or by
the Cardiologists.

15. 24 HOUR HOLTER MONITORING
HOLTER LEAD PLACEMENT
(EDAN)
RED
(CH +)
Left Anterior Axillary line 6th rib.
WHITE
(CH -)
Right Manubrial border of the
Sternum.
BROWN
(CH 2+)
Approximately 1 inch right of
Xiphoid Process on the rib.
BLACK
(CH 2-)
Left Manubrial border of the
Sternum.
GREEN (RL) Lower rigth rib margin over bone.
ORANGE
(CH 3+)
Left mid-clavicular line 6th rib.
BLUE
(CH 3-)
Center of the manubrium.

16. 24 HOUR HOLTER MONITORING:
SAFETY USE INSTRUCTIONS
• Holter machine should not be worn in contact
with skin.
• Record in your diary the time, Location,
activity, Chest Pain/tightness/palpitation, self
feeling in detail.
• Do not:
1.Bath or shower, do not get the recorder wet.
2.Do not touch electrodes or unplug leads.
3.Do not open the recorder, remove the SD
card, or the battery.
4.Do not place mobile, TV or other electrical
appliances one meter around the recorder.
5.Do not place heat source like heater close to
recorder.
Time Location Activity Symptoms
Self Feeling in
Detail
6:00 Left Chest Eating Tightness Worried

17. 24 HOUR HOLTER MONITORING:
SAFETY USE INSTRUCTIONS

18. 24 HOUR HOLTER MONITORING:
SAFETY USE INSTRUCTIONS
• Record in your diary the time, Location,
activity, Chest Pain/tightness/palpitation, self
feeling in detail.
1.Relax the arm and DO NOT talk while the
readings are being taken
2.If driving and the cuff inflates, ignore then
may pull over safely.
3.DO NOT get the monitor wet.
4.When sleeping secure the tubing and keep it
intact.
5. DO NOT bend or squeeze the tubing.
Time Activity Symptoms
Self Feeling in
Detail
6:00 Eating Nape pain Worried

19. TREADMILL STRESS TEST
GUIDELINES FOR STRESSTEST
 Stresstest is a specialized cardiac examination
which needs trained nurses to perform the
procedure. This procedure is elective and
proper scheduling is important to prepare
patient for the test.
 Proper patient orientation should be performed
before and during the procedure. Cardiac
monitor with defibrillator and emergency cart
should be in place during every stresstest
procedure.
 Nurse can start Pre-Test per order of the
cardiologist, but the stresstest procedure should
be accompanied by a cardiologist.

21. 1.NPO or light meal at least 2 hours
prior to test.
2. No alcohol intake 48 hours prior.
3. No caffeine or smoking in the morning
of the test day.
4. Stop beta blockers: Metropolol,
propanolol, etc. if patient has any of
these drugs, conform first to AP
regarding temporary discontinuance of
the drug.
5. Be in sports attire: tennis shoes with
socks, jogging pants and loose t-shirts.
6. Bring bottled water and towel.

22. AUDIOMETRY (ADULT) & NEWBORN
HEARING SCREENING
GUIDELINES FOR AUDIOMETRY TEST
Audiometry procedure provides services
to OP adult patients and neonates who is
required to undergo newborn hearing
screening test.

25. SERVICES:
 NEBULIZATION
 INCENTIVE SPIROMETRY
 CHEST PHYSIOTHERAPY
(CPT)
 PULMONARY FUNCTION
TEST
 ARTERIAL BLOOD GAS
TESTING
 VENTILATOR, BIPAP,CPAP.

26. Student Nurses’ duties and
responsibilities
 Performs and assist Respiratory Aide in
nebulization according to the Doctors’
Orders.
 Provides health education for patients and
family.
 Documents all necessary data for patient
registration.
 Monitors and maintains the use of unit
facilities and equipment.
 Maintains cleanliness and orderliness of the
HPC Unit.

30. SERVICES:
 CHEMOTHERAPY
 BLOOD TRANSFUSION
 PHLEBOTOMY
 PARACENTESIS
 FACTOR VIII INFUSION
 BONE MARROW
ASPIRATION

32. Monitor patient vital signs,
signs and symptoms for any
reactions.
End chemotherapy or
procedure.
Discontinue IVF.
Discard all used supplies in
cytotoxic container or other
designated bins according to
type .