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110_Cardiac > Angina and MI > Flashcards

Angina and MI Flashcards

(65 cards)

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1
Q

CAD (Coronary Artery Disease) Meds

A

Cholestrol meds ezetimibe (Zetia)
Robostatin
Aspirin
Statin
Given at night. Body at rest. Artery are hardened

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2
Q

Angina

A

Coronary Spasm
Not true MI

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3
Q

Chronic Angina

A

intermittent chest pain (on/off)
Resting disappears
Walk & Activity appears

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4
Q

Qn to ask

What is the presipitation of your pain

A

PQRST
P = Provoking factors - what precipitated the pain?
Q = Quality
R = Region (arm/leg)
S = Severity of Pain
T = Timing of Pain

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5
Q

Best indicator of MI

A

Troponin

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6
Q

Prinzmetal Angina is

A

Chronic Angina that is
Coronary Artery Spasm with/ without CAD (coronary artery disease)

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7
Q

Drug of choice for Prinzmetal Angina or Chronic Angina

A

Diltiazem

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8
Q

Drugs for Prinzmetal Angina

A

CCB + Nitro (SL) + Beta blockers

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9
Q

BP high give

A

Amlodipine (Norvosac)
Amlodipine (Norvasc) is one of the first-choice medication options for treating high blood pressure. Additionally, amlodipine (Norvasc) is also a top-choice medication for treating CAD.

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10
Q

Nursing intervention MI

A

Position Patient semi-flowers position

Normal cause of ischemia is lack of oxygen
chest pain = no oxygen = sit patient = pt able to breathe better

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11
Q

1 cause of chest pain is

A

blockage

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12
Q

1 thing to do

A

Apply O2

Ischemia is #1 cause = No oxygen in part of heart

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13
Q

Med for for Chest Pain

A

ONAM
Apply O2
Nitro
Aspirin
Morphine

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14
Q

Drug of choice for chest pain

A

Morphine lessens cardiac workload

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15
Q

Nursing Interventions for MI

A

EKG
Chest X-ray to know heart or lung problem
Troponin
CRP
Electron Beam Tomography
Exercise Stress Test
Coronary Computed Tomography Angiography

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16
Q

Before Angiography
Patient Teaching before
Cardiac Catherization «Test»

A

Check for Iodine Allergy
Avoid Metaformin
Renal function test
Teach you will feel flushing = warmth > flash>jumping ###exam

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17
Q

Gold Standard to remove heart blocks

A

Cardiac Catherization

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18
Q

CABG

A

less intervention

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19
Q

PCI (Percutaneous Coronary Intervention) Assess

A

> Check allergy
Base line Vital Sign = BP normal
give metoprolol for increased BP.
Check pulse ox, HR, RR
Labs: Troponin, CBC, Hgb/Hct
In stenting = lot of blood is lost
Administer drugs
Pt education post procedure

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20
Q

CAD (Coronary Artery Disease)
2 sub divisions

A
  1. Chronic Stable Angina
  2. Acute Coronary Syndrome (ACS).
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21
Q

Chronic Stable Angina can become

A

Acute

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22
Q

ACS = 2 subdivision

A
  1. NSTEMI - Unstable Angina Non-ST segment eleveation MI
  2. STEMI -ST- Segment Elevation MI
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23
Q

Unstable Angina is the same as

A

NSTEMI

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24
Q

With ST elevation

A

Troponin elevation greater than 0.5

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25
ACS == Unstable Angina
New Onset
26
Tx unstable angina
Thrombolytic administered within 6 hours of start of chest pain.
27
ACS = Myocardial Infaraction (MI)
You have the blockage, and it is not complete blockage
28
Ask Pt history?
Hx of CAD, Preexisitng genetic condition
29
STEMI occlusive thrombosis means ST elevation which can lead to
infarctions
30
treatment for STEMI
1. Artery must be open with PCI within 12 to 72 hours 2. Thrombolytic to be administered
31
2 types of blocks
1. Occlusive 2. Non-occlusibe
32
STEMI or NSTEMI Rule
Fix it within 90 mins
33
Sign of MI
Chest pain occurs early in the morning greater than 20 mins
34
No pain if
cardiac neuropathy Note : diabetes they have pain
35
With MI intially and then
Initially HR high trying to compensate, then stops.
36
S/s of MI
Initially HR high BP low Juglar vein distention Abnormal HR
37
If BP = 90/70
I am giving fluids to increase cardiac output
38
MI = Hypotensive = cardiac o/p low so ----
Renal o/p low. Oliguria, BUN high Heart is not pumping to perfuse kidney
39
Carida output problem is the
Kidney problem
40
Clinical Manifestations of MI (4)
1 N&V 2. Increase temp with injury to the heart with MI 3. Heaviness = SOB - feels like elephant sitting on chest
41
Mi leads to
v-fib (dysrhythmias) Heart is trying to compensate V-fib/ V-tach
42
MI complication is
HF
43
Complication of MI
Dysrhythmias LHF = Pulmonary Edema (water in the lungs) RHF = Edema all over the body.
44
Main Complication of MI
Cardiogenic Shock Decreased oxygen and nutrients to the heart Fast Pulse, HR increased, RR increased Eventually everything will go down BP low
45
In all shocks = septic, stroke shock cardiogenic shock
BP down
46
MI = Cadiogenic shock then
Intubate the pt./ no perfusion in lungs Prevent VAP = Turn, Cough, Deep Breathe While suctioning with catether = no suction while inserting, and then suction on taking out fast. Hyperoxygenate the pt. first
47
ACS Diagnostic Studies
Always choose 12-lead EKG (STEMI/ NSTEMI observed) Lab Troponin high Electrolytes abnormal Draw troponin every 8 H - cardiac biomarkers EKG every 24 H
48
Problem detected MI (Troponin high)
Cardiac Catherization is done within 90 mins for STEMI and need PCI or CABG as per pt. confition
49
Nursing Care and Interprofessional Care ACS (Acute Coronary Syndrome)
Pt. semi-flowers or flowers position, Put oxygen 2 IV in pt with MI Give medication ONAM, then statin
50
Unstable Angina = NSTEMI medication
(1) Give Heparin which is not a thromobyltic bit an anticoagulant Thrombolytics are clot buster or dissolves Anticoagulant are blood thinner or prevents clots (2) Glycoprotein lob/ IIIa inhibitors
51
ACS interprofessional care
Remember table in your text
52
Chronic = not ICU
Acute = ICU = Continuous EKG
53
All MI Bed Rest
Pee in Bed, Eat in Bed NOT WALKING # Bed rest for MI
54
Check Interprofessional Mgmt
Heparin - UA & NSTEMI DAPT = NSTEMI and UA with stent Aspirin UA Cardiac catherization = Reperfusion = STEMI = Thrombolytic Therapy
55
Evaluation for STEMI
Neuro, Pupils, the way they move
56
MI STEMI
Administration of IV within 30 mins of arrival
57
STEMI
Thromobolytic therapy - available and rapid administration if not PCI capable. or Give meds awaiting for PCI
58
Acute treatment
1st treatment for acute MI is PCI Goal open block heart = oxygenation and perfusion into heart. Give nitro drip = vasodilation BP falls= hypotension - headache = dilation
59
Thormbolytic thearpy Caution
Pt will bleed. Get Hemostat Gauze, do blood work before for coagulation panel Plt, aPTT and PTT.
60
Thrombolytic Therapy done for
Chest Pain less than 12 hours 12 Lead KKG shows STEMI No absolute blood dyscrasia/ hemophilia
61
repurfusion after Heart Attack
ST segment returns to baseline. PCI done - we have reperfusion Heart is back No check pain Rapid rise fo serum bio markers - peak within 12 hours Reperfusion dyrhytjmisa less reliable indicator.
62
Scaring of heart
1st degree heart block/ PAC/ Ventricular Cardiac arrhythmias
63
Major concern after HA
Reocclusion, so give IV Heparin Monitor chest pain and ECG changes
64
Major complication of Heparin
Bleeding dafety alert s/s of bleeding complication: - abdominal pain - Check for blood in urine and BM - blood in eyes, ear, and lungs
65
Meds for ACS
Ace Inhibitors Norvac (Amlodapine) Verapamil Antidyrrhythmic drugs colase lipid-lowering drugs (statins) stool softner

110_Cardiac (8 decks)

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