Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
29 Cards in this Set
- Front
- Back
|
PRECIPITATING FACTORS OF MI:
|
OCCURS AT REST OW WITH MODERATE ACTIVITY
-LOW ACTIVITY IS A RISK FACTOR -PEAK INCIDENCE 6AM-NOON, MONDAYS |
|
|
S/S OF MI
|
1.CHEST PAIN DESPITE REST & MEDS (FOR 30 MINS)
2.ANXIETY & RESTLESSNESS 3.INCREASED HR & RR 4.SHORTNESS OF BREATH 5.NAUSEA |
|
|
WHAT ARE THE 3 I'S OF CORONARY ARTERY EVENTS?
|
1.ISCHEMIA
2.INJURY 3.INFARCTION |
|
|
ECHOCARDIOGRAM
|
USED TO EVALUATE CARDIAC FCN,SPEC VENTRICULAR FCN
-CAN DETERMINE EJECTION FRACTION |
|
|
ISCHEMIA
|
CHEST PAIN/ANGINA
CAN BE REDUCED BY:BETA-BLOCKERS (SLOW RATE) OR VASODILATION W/NITROGLYCERIN -FIRST SEE LARGE & SYMMETRIC T WAVES FOR 24 HRS & THEN T WAVE INVERSION ON THE EKG W/IN 1-3 DAYS.LASTS 1-2 WKS |
|
|
INFARCTION
|
ACTUAL DEATH OF THE INJURED MYOCARDIAL CELLS
-CPK,TROPONINS,MYOGLOBLIN LEAK INTO BLD -BEGINS W/IN 40-2 HRS (90%COMPLETE IN 6 HRS) -SIGNIFICANT Q WAVES DEV IN 1-3 DAYS |
|
|
DIAGNOSIS OF MI BASED ON:
|
**ST ELEVATION**,T WAVE INVERSION
HISTORY,ECG,LAB TESTS |
|
|
WHICH LAB TEST (SERUM MARKERS) IS BEST FOR DETERMINING A MI?
|
CK-MB HEART MUSCLE
-INCREASES WHEN A MI -STARTS TO INCREASE 3-6 HRS & PEAKS WITHIN 24 HRS OF AN MI RETURNS TO NORMAL IN 3 DAYS |
|
|
MY0CARDIAL INFARCTION
|
PROCESS BY WHICH MYOCARDIAL CELLS IN THE HEART ARE PERMANENTLY DESTROYED
|
|
|
NORMALLY LDH-1 IS LESS THAN LDH-2,AFTER AN MI...
|
LDH-1 > LDH-2
LDH RISES IN 24-48 HRS,PEAKS IN 48-72 HRS,AND RETURNS TO NORMAL IN 5-10 DAYS |
|
|
INJURY
|
OCCURS IF ISCHEMIA LASTS > FEW MINS
OCCURS W/IN 20-40 MINS AFTER BLOCKAGE PAIN IS SEVERE -ST SEGMENT ELEVATION>1MM OVER BASELINE SEEN IN THE LEADS OVER OR FACING MI.RETURNS TO NORMAL IN 1-6 WKS |
|
|
WHEN SHOULD AN ECG BE DONE?
WHAT DOES IT SHOW? |
1.WITHIN 10 MIN OF ENTERING ED
2.LOCATION,EVOLUTION,RESOLUTION OF MI |
|
|
CAUSES OF MI:
|
1.REDUCED BLD FLOW
2.VASOSPASM 3.DECREASED OXYGEN SUPPLY (ANEMIA,LOW BP) 4.INCREASED DEMAND FOR OXYGEN (RAPID HR,THYROTOXICOSIS,COCAINE) |
|
|
MYOGLOBIN
|
A HEME PROTEIN
INCREASES IN 1-2 HRS & PEAKS 6 HRS AFTER ONSET ***NO SPECIFIC TO INDICATE AN MI**** |
|
|
TROPONIN
|
HAS 3 ISOMERS:C,I,T-T OR I IS USED FOR CARDIAC
-INCREASES IN 4-6 HRS,PEAKS 10-24 HRS -REMAINS ELEVATED FOR 5-7 DAYS |
|
|
WHICH LOCATION OF AN MI HAS THE HIGHEST MORTALITY RATE?
|
ANTERIOR LAD (LEFT ANTERIOR DESCENDING)
-TACHYCARDIA -CHF,CARDIOGENIC SHOCK,V.ANEURYSM,A FIB |
|
|
WHICH LOCATION OF AN MI IS TREATED W/ GIVING FLUID?
|
RIGHT VENTRICULAR (RCA)
-DYSRHYTHMIAS,SINUS BRADY -RIGHT VENTRICULAR FAILURE,PAPILLARY MUSCLE RUPTURE |
|
|
GOAL OF MED MANAGEMENT OF MI
|
MINIMIZE MYOCARDIAL DAMAGE
PRESERVE MYOCARDIAL FCN PREVENT COMPLICATIONS |
|
|
WHAT IS TO BE DONE FOR A PT COMING INTO ED FOR MI?
|
1ST 10 MINS-IMMEDIATE ASSESSMENT
2."MONA" |
|
|
WHAT DOES "MONA" GREETS ALL PTS STAND FOR?
|
1.MORPHINE
2.OXYGEN 3.NITROGLYCERIN 4.ASPIRIN |
|
|
OXYGEN IS TO BE GIVEN AT__ L/MIN
YOU WANT PULSE OX TO BE GREATER THAN__ |
O2 AT 4 L/MIN
PULSE OX >93% |
|
|
NITOGLYCERIN IS GIVEN___
WHAT DOES IT DO? |
SL OR IV
.04 MG..MAY REPEAT TWICE AT 5 MIN INTERVAL (TOTAL OF 3 TABS) -DILATES PRIMARILY THE VEINS (DECREASED PRELOAD)BUT ALSO ARTERIES(DECREASED AFTERLOAD) -REDUCES MYOCARDIAL |
|
|
ASPIRIN IS TO BE GIVEN AT ___
WHAT DOES IT DO? |
160-325 MG
PREVENTS PLATELET AGGREGATION SHOULD BE CHEWABLE |
|
|
MORPHINE SHOULD BE GIVEN __
WHAT DOES IT DO? WHAT ARE S/S OF OVERDOSE? |
IV 1-3 MG DOSES REPEATED AT 5 MIN INTERVALS AS NEEDED (SOME PTS MAY NEED 30 MG)
-REDUCES PAIN & ANXIETY -REDUCES PRELOAD **OVERDOSE=RESP DEPRESSION AND LOW BP** |
|
|
THROMBOYTIC THERAPY
|
DISSOLVE & LYSE THE THROMBUS IN THE CORONARY ARTERY ALLOWING BLD TO FLOW THROUGH THE CORONARY ARTERY AGAIN
-MINIMIZES THE SIZE OF INFARCTION & PRESERVES VENTRICULAR FCN |
|
|
IN ORDER FOR THROMBOLYTIC THERAPY TO BE EFFECTIVE,IT MUST BE ADMINISTERED..
|
AS EARLY AS POSSIBLE
DOOR TO NEEDLE TIME SHOULD BE LESS THAN 30 MIN GIVE WITHIN 6 HRS |
|
|
WHAT ARE THE 2 TYPES OF THROMBOYLYTIC AGENTS USED?
|
1.STREPTOKINASE-MADE FROM STREP BACTERIA **RISK OF ALLERGIC RXN**
1ST GIVE ANTIHISTAMINE 2.TPA-TISSUE PLASMINOGEN ACTIVATOR **MORE CLOT SPECIFIC & SHORTER HALF LIFE** |
|
|
WHAT ARE THE S/S OF BLEEDING
|
1.DECREASED HCT AND HGB
2.LOW BP 3.INCREASED HR |
|
|
FOR MAJOR BLEEDING FROM THROMBOLYTIC,WHAT IS TO BE DONE?
|
D/C THROMBOLYTICS,APPLY PRESSURE,NOTIFY MD
|
