Wk 5 MI PowerPoint/2

Question 1

V1 V2

Answer 1

give data about the right heart

Question 2

V5 and V6 give data on

Answer 2

the left side of heart

Question 3

P wave

Answer 3

atrial systole (contraction)

Question 4

QRS complex

Answer 4

ventricular systole

Question 5

T wave

Answer 5

ventricular diastole (relaxation)

Question 6

LBBB can be indicator for

Answer 6

MI

Question 7

ST depression

Answer 7

ischemic change

Question 8

MI damage - causes Q wave on EKG

Answer 8

area of infarction - oxygen deprived damage, irreversible

Question 9

causes S-T segment elevation of EKG

Answer 9

area of injury - next to infarct, tissue is viable as long as circulation remains adequate

Question 10

result of sustained ischemia

Answer 10

MI

Question 11

MI minutes that cause sustained ischemia

Answer 11

> 20 mins

Question 12

necrosis of entire thickness of myocardium takes how long

Answer 12

4-6 hours

Question 13

most MIs involved what area of heart

Answer 13

LV

Question 14

transmural MI aka

Answer 14

full thickness

Question 15

normal trop I

Answer 15

< .2 ng/L

Question 16

trop 1 onset

Answer 16

3-5 hours

Question 17

trop I is no longer evident when

Answer 17

after 7 days

Question 18

trop T normal

Answer 18

< .03 ng/L

Question 19

trop T onset

Answer 19

3 hours

Question 20

trop T no longer evident after

Answer 20

14 days

Question 21

Creatine kinase - MB

Answer 21

the MB band is specific to heart muscle cells

Question 22

CK MB is not longer evident after

Answer 22

3 days

Question 23

myoglobin is no longer evident after

Answer 23

24 hours - limited specificity

Question 24

shockable EKG readings

Answer 24

vtach

vfib

Question 25

MI complication - papillary muscle dysfunction is

Answer 25

MI is near mitral valve

Question 26

MI complication - dressler syndrome

Answer 26

pericarditis and fever 1-8 weeks post MI

Question 27

most common MI complication

Answer 27

dysrhythmias

Question 28

MI complications - life threatening dysrhythmias seen most often with 3

Answer 28

1. anterior MI 2. heart failure 3. shock

Question 29

have to have normal what to go to cath lab and get dye insertion

Answer 29

certinine levels

Question 30

thrombolytic agent

Answer 30

TNK, stimulates own plasma clotting factor in blood to decrease any clot size

Question 31

time frame - when can't give thrombolytic agent

Answer 31

if heart attack was greater than 6 hours ago

Question 32

tx of choice for confirmed MI

Answer 32

PCI - percutaneous coronary intervention

Question 33

PCI

Answer 33

balloon angioplasty + drug eluting stent

Question 34

PCI - ambulatory when

Answer 34

24 hours after

Question 35

can PCI be used for UA too

Answer 35

yes

Question 36

nursing care for PCI - preprocedure | 5

Answer 36

1. ensure consent is signed 2. keep NPO 3. assess for iodine/shellfish allergy 4. administer sedatives and analgesics 5. monitor

Question 37

nursing care for PCI - postprocedure | 7

Answer 37

1. VSs 2. groin bleeding 3. assess pedal pulse, color, temp 4. bedrest 4-6 hours 5. monitor 6. assist with sheath removal 7. patient education

Question 38

fibrinolytic therapy marker of reperfusion

Answer 38

return of ST segment to baseline

Question 39

two main thrombolytics

Answer 39

1. streptokinase | 2. alteplase

Question 40

thrombolytics contraindications | 9

Answer 40

1. intracranial hemorrhage 2. AVM 3. neoplasm 4. < 3 mo CVA 5. trauma 6. spinal surgery 7. uncontrolled HTN 8. aortic dissection 9. bleeding

Question 41

morphine main risk is

Answer 41

respiratory depression and low BP from vasodilation

Question 42

before beta blocker admin, check for

Answer 42

low BP

Question 43

drug of choice for cholesterol lowering

Answer 43

statins

Question 44

cholesterol lowering drugs - assess | 2

Answer 44

1. assess liver enzymes ALT and AST | 2. assess for rhabdomylysis - muscle pain

Question 45

CCB don't get what

Answer 45

pregnant

Question 46

CCB diet

Answer 46

no grapefruit juice

Question 47

what to give for prinzmetal angina

Answer 47

beta or calcium ch blockers

Question 48

why do you give niacin

Answer 48

vasodilation

Question 49

AA pts don't response to what class of drugs

Answer 49

ACE inhibitors - give beta blockers or CCB

Question 50

most Pulmonary embolus is from what vessel

Answer 50

popliteal

Question 51

risk factors for PE | 3

Answer 51

1. infection causing hyper coagulation state 2. cancer 3. long plane rides, over 4 hours

Question 52

best dx for DVT/PE

Answer 52

CAT scan

Question 53

DVT/PE tx

Answer 53

factor 10a inhibitors

Question 54

low molecular weight heparin name

Answer 54

enoxaparin/lovenox

Question 55

heparin - monitor what

Answer 55

aPTT - normal 1.5-2

Question 56

normal INR

Answer 56

2-3