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50 Cards in this Set
- Front
- Back
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Acute coronary syndromes represent a spectrum of ischemic myocardial events that share similar pathophysiology. 3 of these are
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Unstable Angina
Non-ST Elevation MI ST Elevation MI |
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Diagnosis of ACS looks at
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presentation
blood tests diagnostic tests |
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2 blood tests for ACS are
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Cardiac Markers (troponin) and CBC
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3 diagnostic tests for ACS are
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electrocardiography
echocardiography nuclear imaging |
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Diagnosis of Unstable Angina is made when there are symptoms, _______ cardiac markers and ECG changes _____ and _____.
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negative
ST segment depression T wave inversion |
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Diagnosis of Non-STEMI is made when there are symptoms, _______ cardiac markers and ECG changes _____ and _____.
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elevated
ST segment depression T wave inversion |
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Diagnosis of STEMI is made when there are symptoms, _______ cardiac markers and ECG changes _____, _____ and _____.
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elevated
ST segment elevated T wave inversion Prominent Q wave |
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Typical chest discomfort is described as
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-pressure, tight, squeezing, heaviness, burning
-behind sternum across upper chest -radiating to arms, shoulders, neck, back, jaw -possible nausea, diaphoresis, dyspnea, palpitations |
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Atypical symptoms for women and elderly include:
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-indigestion
-nausea -vomiting -upper back and shoulder pain |
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3 cardiac markers that are drawn when a person has CP are
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troponin
CPK Myoglobin |
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Cardiac Markers and CBC distinguish patients with ____ from those with a ____.
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unstable angina
MI |
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A patient will have an elevated WBC count when they have an _____ because it is an inflammatory response.
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MI
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____ are within myocytes that are within the myocardium and help with contractility.
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Troponins
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Troponins are a ____ specific protein that are released following cell death.
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cardiac
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Diagnosis of MI is made with either Troponin ___ or ___.
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T or I
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Troponin serum levels are elevated within 2-4 hours of an MI and persists for _____.
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7-14 days
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____ is the portion of a Total CPK that shows MI because it is released specifically from injured heart muscle.
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CK-MB
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CK-MB levels are elevated within 4-8hrs of an MI and return to normal within ____.
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72 hours
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____ is a protein found in cardiac and skeletal muscles that helps support the diagnosis of an MI.
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Myoglobin
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Myoglobin serum levels are elevated within 2-3 hours of an MI and return to normal within ____.
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24 hours
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ST segment depression and inverted T waves indicate ____ or _____.
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unstable angina or NSTEMI
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St segment elevation, T wave inversion and a Prominent Q wave indicate _____.
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STEMI
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Raised troponin levels indicate ____ or ____.
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NSTEMI or STEMI
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Acute MI damages the ____ layer of the heart first.
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endocardium
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With a NSTEMI infarction is limited to
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subendocardium
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During an acute MI if sufficient blood flow is not restored tissue necrosis will occur in at least 1/2 or all 3 layers. This is known as _____.
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STEMI
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____ is death or irreversible damage of myocardial cells.
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Acute MI
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Acute MI is usually caused by rupture of atherosclerotic plaque and subsequent _____.
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thrombus formation
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Within 20-40 minutes of an Acute MI myocardial damage begins. The extent is limited by
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quick return of blood flow.
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40-50% of Acute MIs are caused by obstruction of the ______.
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LAD coronary artery
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A MI occurs when the vessel becomes partially or totally occluded due to
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rupture of plaque and a clot forms.
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After plaque ruptures the platelets will adhere, activate and aggregate causing a
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temporary platelet plug.
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The arterial thrombus is held in place by _____.
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fibrin
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The immediate Tx goals of a person with an AMI is
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-relieve chest pain
-maintain CV stability -decrease cardiac workload |
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____ are used in the treatment and prevention of MI, stroke and other CV events.
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Antiplatelet drugs
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4 antiplatelet drugs are
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Aspirin
Plavix Effient Brilinta |
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Aspirin works _____ the platelet.
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inside
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Aspirin decreases ____ production inside the platelet which inhibits platelet activation and aggregation.
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TXA2
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Plavix, Effient, and Brilinta work with membrane receptors that are ____ the platelet.
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on
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Plavix, Effient, and Brilinta block ADP receptors on the platelet which prevents ADP from attaching to platelet and receptors, therefore the platelets don't _______.
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clump or aggregate
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The major problem with anti-platelets is _____.
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bleeding
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_____ dissolve clots that are blocking the coronary arteries.
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Fibrinolytics/Thrombolytics
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Goals of Fibrinolytic therapy are
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dissolve clots that are obstructing the coronary arteries and restore circulation to the myocardium
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2 fibrinolytic medications are
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Streptokinase and Tissue Plasminogen Activator (TPA)
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Adverse effects of Fibrinolytics are
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-BLEEDING
-blood in urine -unexplained bruising, occult bleeding, IV oozing |
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____ is a medication for acute MI that is used to eliminate pain.
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Morphine sulfate
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Morphine sulfate dilates both the venous and arterial beds resulting in decreased ____ and ____.
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preload and afterload
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Morphine sulfate binds with opioid receptor sites in the brain which results in diminished transmission of ____ and therefore a decrease in myocardial workload.
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pain impulses
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Morphine sulfate should not lower ____ or ____.
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BP or HR
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Nursing care for a patient taking Morphine sulfate includes:
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assess R
monitor circulation monitor pain monitor VS and oxygen sat. |
