MI, Angina, CAD

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

MI, Angina, CAD

Med Surg: Cardiac

Pathophysiology Diagnostics
Myocardial Infarction (MI) the heart muscles DIE “necrosis” 1st–EKG
from lack of oxygen. This occurs when there is a (Any chest pain or MI symptoms)
blockage of the coronary arteries, the “O2 tubes”
feeding the heart oxygen.

Signs & Symptoms


O2

PAIN–Jaw, back, mid back/shoulder pain, heartburn (epigastric),


Substernal NormalNormal ST elevation
ST elevation ST Depression
Key words = priority: “Sudden” “Crushing” “radiating” NCLEX TIP
SOB “dyspnea” “labored breathing”
NAUSEA Vomiting “Abdominal pain”
SWEATING “Diaphoresis”
PALE COOL SKIN “dusky”
ANXIETY

Causes
SODDA 2nd–LABS
T–Troponin (Over 0.5 ng/mL)
S–Stress, Smoking, Stimulants (caffeine, amphetamines) T–Trauma (ONLY indicator of MI)
O–Obesity–(BMI over 25) Other labs: Crp, Ckmb,
D–Diabetes & HTN (over 140/90) Myoglobin, CRP (inflammation)
D–Diet (high cholesterol) animal fats
A–African American males & Age (over 50) Treatment: Pharmacology
*Men more than women
DURING–Any Chest Pain
Progression O–Oxygen
A–Asa
CAM N–Nitro–under tongue x 3 Max
M–Morphine - Any pain after = MI (injury)
C–CAD “coronary artery disease”
A–ACS “acute coronary syndrome” AFTER–MI
Angina - Stable “Safer”- relieved w/rest
Clot Stabilization:
Angina - Unstable “Unsafe” - Unrelieved Heparin: prevents CLOT growth (NOT dissolve only t-PA)
M–MI (heart die) PTT: 46 - 70 “3 x MAX” Antidote: Protamine Sulfate
Memory Trick: “HaPTT” frog
Heart Rest:
B–Beta Blockers (-lol) Atenolol
Blocks both BP & HR (Lol = Low BP & HR)
CAUTION:
B–Bad for Heart Failure patients (CHF)
Patient Education B–Bradycardia (60 or Less) & BP low (HR LESS than 60)
B–Breathing Problems “wheezing” (Asthma, COPD)
DRESS B–Blood sugar masking “hides s/s” (Diabetics)
C–Calcium Channel Blockers
D–Diet low (sodium & fluids (2g/2L per day) Calms BP & HR-(AVOID Low Hr & BP)
Prevent HF Heart Failure=Heavy Fluid (Nifedipine, Diltiazem, Verapamil)
-dipine “declined BP & HR”
Report "New, Rapid" Weight Gain-Water Gain! -zem “zen yoga for heart”
R–Reduce Stress, Alcohol, Caffeine, Cholesterol (animal fats) -amil “chill heart”
E–Exercise (30 min x 5 days/wk) D–Dilators (vasOdilators = O2 to heart)
Nitroprusside (only for HTN crisis) & Isosorbide
S–Smoking Cessation Nitro “Pillow for heart”
S–Sex (2 flights of stairs with NO SOB) NCLEX TIP NO viagra “-afil” Sildenafil = DEATH!
*AVOID NSAIDS (naproxen, ibuprofens) = increases CLOT risk! Nitro drip: STOP if Systolic BP below 90 or 30 mmHg Drop
SE: HA is Common + SLOW Positions changes “syncope” t

Treatment: Pharmacology DISCHARGE–GOING HOME


AC–Anti Clogging of Arteries CHOLESTEROL
Heart Rest:
1st choice A–Ace (-pril) Lisonopril “chill pril”
A–Antiplatelet HOLD if: Platelets 50K or LESS PANEL 2nd choice A–ARBs (-sartan) Losartan “relax man”
“below 50 gets risky” (not INR, not aPTT) Antihypertensive (BP ONLY) *HOLD: Low BP (not HR)
A–ASA C-CLOGGED ARTERIES (risk) Precautions:
A–Avoid Pregnancy
C–Clopidogrel 200 or Less-Total Cholesterol A–Angioedema “thick tongue”
C–Cholesterol Lowering “-Statin” 150 or Less-Triglycerides (Airway Risk) *only Ace NCLEX TIP
100 or Less-LDL C–Cough *only Ace
Lovastatin “stay clean”
Creatinine (Kidney) (normal: 0.9 -1.2) *only Ace
CAUTION: 40 or More = HDL
E–Elevated K+ (normal 3.5-5.0) NCLEX TIP
NO grapefruit AVOID Salt Substitues + Green Leafy veggies
Liver Toxic–report “clay colored stools” • 1st–Cardiac Monitor
• High Potassium = High Pump
Muscle pain (Rhabdomyolysis risk) • Monitor: muscle cramps, spasms,
Late night–take at dinner peaked T waves, ST changes

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy