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9 Cards in this Set

  • Front
  • Back
If a patient is having non ST elevated chest pain, what meds should they be on and what is your course of action?
-should be on sublingual NTG, 325mg aspirin, morphine, O2. They should be hooked up to EKG, and OBSERVED.
- treat as if they are having an MI.
If a patient has non ST elevated chest pain, but there chest pain continues what test beyond cardiac enzymes are we going to order- what are we looking for?
-order an ECHO to look for pericardial effusion, LV function, akinesia, thrombus in coronary vessels. Depending on what we see in terms of occlusion of coronary vessels, we might order patient to undergo angiography.
How long do we have in ST elevation until 90% of myocardial ischemic area dies?
- 3hrs
If a coronary artery is completely occluded then reopened, what are the chances that the affected myocardium will return to normal?
very high; within hour/days
In terms of time, how long would chest pain last that would make the clinician highly suspect of an MI over GI or musculoskeletal pain (particularly if patient is elderly or DM)?
A. 30-40 min.
B. 20-30 min
C. 60-120 min.
D. 2hrs- 3hrs
-A. 30-40 min
What is one of the biggest side effects of NTG? When kind of HF is most likely the patient NOT going to be on NTG?
-headache; right sided HF usually is associated with hypotension and thus the patient should not be on NTG.
What are some examples of reperfusion?
Reperfusion is the restoration of blood flow to an area that was previously deprived of adequate circulation. This can be done with balloon angioplasty, stent placement, or thrombolytic therapy (such as a streptokinase based product).
What is the window of opportunity to use reperfusion therapy?
12 hrs after the event. The patient must be < 75yrs/old
Prior to hospital discharge, what are some patient characteristics we are looking at to determine predictors of mortality?
ECHO- assess LVF
Stress test: treadmill or w/ dobutamine
EKG: looking for any disrrhythmias