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Health Devations Involving CV Functions

STUDY
PLAY
Transmural
Full thickness
Subendocardial
partial thickness
LAD
Anterior LV
LAD
Septal
RCA
Inferior LV
L Circumflex
Lateral LV
L Circumflex
Posterior LV
RCA
RV
C-Reactive Protein
An inflammatory mediator that is the best predictor of an upcoming MI
Homocysteine
An inflammatory mediator that is a good predictor of an upcoming MI, but not as good as C-Reactive Protein
sleep disturbance (60%), SOB (63%), and Fatigue (70%)
common atypical manifestations of an MI
SOB, syncope
Common atypical MI SS of elderly (>85)
Fibrinolysis requirements
Significant ST elevation, Ongoing chest discomfort (>20min & <12h), oriented, and>35 yo (males) >40 yo (females)
Troponin I
The gold standard and most specific lab test for an MI
Myoglobin
the fastest lab test for an MI
Doubles, 2h
If myoglobin ______ in _________ it is a good indication an MI has occured
STEMI
ST elevation indicates
Unstable angina or Non STEMI
ST depressions indicates
> 1mm, 2 buddy leads
In order for ST elevation to be "significant" it must be ______ and in _________
Ischemic, injured
_____ and _______ tissue can be saved
Infarct
Cannot be saved
tall or inverted T wave
Ischemia is indicated by a _________
Elevation
Injury is indicated by ST segment __________
Infarction (Acute)
is indicated by an abnormal Q wave, possible ST seg elevation, and possible t wave inversion
Infarction (Age unknown)
is indicated by an abnormal Q wave where the ST seg and T wave have returned to normal
Limit infarct size, reprofuse, and prevent complications
Goals and treatment of an MI include
Opioid/Morphine
Used to treat pain/discomfort from an MI
2-4 mg q.5-10 min, pushed over 5 min
Dose of morphine for a MI
0
Goal for pain level when treating an MI
discontinue
After an MI you should ________ all NSAIDA except ASA
< 90%, other signs of hypoxia
Only give O2 if SpO2 is _______ or there are ______
160-325, chewed
Give __________ mg of ASA and the tab should be ______
Indications for Fibrinolytic therapy
Significant ST elevation, time of onset >20 min <12h, caution death from brain hemorrhage esp if >75 yo
30 min
door to drug time for fibrinolytic therapy is
90 min
Door to treatment time for Percutaneous Transluminal Coronary Angioplasty (PTCA) is
90%
First try success rate of PTCA is
PTCA
The treatment of choice for STEMI if given with in 90 min of admission
STEMI (<90 min), NSTEMI, and Unstable Angina
PTCA can be use to treat
check for allergies to shellfish and iodine
Most important pre PTCA nursing responsabilty is
check for bleeding at site, check for reocclusion (by looking for raised or inverted ST seg), Encourage fluids, and Circ checks (distal to site
Improtant post PTCA nursing responsabilities
ACS with NO st seg elevation
indication for GPIIBIIIA inhibitors (antiplatelet agents)
ReoPro, Integrillin, and Aggrestat
examples of GPIIBIIIA
STEMI or NSTEMI once stable but not in early treatmetn
Indications for Beta Blockers for treatment of an MI
Rest of their life
how long will MI pts be on beta blockers
Rest of their life
How long will a MI pt be on ACE inhibitors
Acute Pain/discomfort
1st priority Nurs Dx of an MI is
Dysrhythmias
Most common complication of an MI
heart failure
2nd most common complication of an MI