lOMoARcPSD|21542507
MI, Angina, CAD - Cardiology study material for ATI - med
surg 1 - from simple Nursing - NCLEX
Medical Surgical Nursing II (Lanier Technical College)
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Downloaded by TUALLA KAL-EL JOHNRAY 3A (kaleltualla1@gmail.com)
lOMoARcPSD|21542507
MI, Angina, CAD
Med Surg: Cardiac
Pathophysiology
Diagnostics
1st–EKG
(Any chest pain or MI symptoms)
Myocardial Infarction (MI) the heart muscles DIE “necrosis”
from lack of oxygen. This occurs when there is a
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
Key words = priority: “Sudden” “Crushing” “radiating” NCLEX TIP
SOB “dyspnea” “labored breathing”
NAUSEA Vomiting “Abdominal pain”
SWEATING “Diaphoresis”
PALE COOL SKIN “dusky”
ANXIETY
Normal
ST elevation
ST elevation
ST Depression
Causes
SODDA
S–Stress, Smoking, Stimulants (caffeine, amphetamines)
O–Obesity–(BMI over 25)
D–Diabetes & HTN (over 140/90)
D–Diet (high cholesterol) animal fats
A–African American males & Age (over 50)
*Men more than women
Progression
CAM
C–CAD “coronary artery disease”
A–ACS “acute coronary syndrome”
Angina - Stable “Safer”- relieved w/rest
Angina - Unstable “Unsafe” - Unrelieved
M–MI (heart die)
Patient Education
DRESS
D–Diet low (sodium & fluids (2g/2L per day)
Prevent HF Heart Failure=Heavy Fluid
Report "New, Rapid" Weight Gain-Water Gain!
R–Reduce Stress, Alcohol, Caffeine, Cholesterol (animal fats)
E–Exercise (30 min x 5 days/wk)
S–Smoking Cessation
S–Sex (2 flights of stairs with NO SOB) NCLEX TIP
*AVOID NSAIDS (naproxen, ibuprofens) = increases CLOT risk!
Treatment: Pharmacology
AC–Anti Clogging of Arteries
2nd–LABS
T–Troponin (Over 0.5 ng/mL)
T–Trauma (ONLY indicator of MI)
Other labs: Crp, Ckmb,
Myoglobin, CRP (inflammation)
Treatment: Pharmacology
DURING–Any Chest Pain
O–Oxygen
A–Asa
N–Nitro–under tongue x 3 Max
M–Morphine - Any pain after = MI (injury)
AFTER–MI
Clot Stabilization:
Heparin: prevents CLOT growth (NOT dissolve only t-PA)
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)
B–Bradycardia (60 or Less) & BP low (HR LESS than 60)
B–Breathing Problems “wheezing” (Asthma, COPD)
B–Blood sugar masking “hides s/s” (Diabetics)
C–Calcium Channel Blockers
Calms BP & HR-(AVOID Low Hr & BP)
(Nifedipine, Diltiazem, Verapamil)
-dipine “declined BP & HR”
-zem “zen yoga for heart”
-amil “chill heart”
D–Dilators (vasOdilators = O2 to heart)
Nitroprusside (only for HTN crisis) & Isosorbide
Nitro “Pillow for heart”
NO viagra “-afil” Sildenafil = DEATH!
Nitro drip: STOP if Systolic BP below 90 or 30 mmHg Drop
SE: HA is Common + SLOW Positions changes “syncope” t
DISCHARGE–GOING HOME
A–Antiplatelet HOLD if: Platelets 50K or LESS
“below 50 gets risky” (not INR, not aPTT)
A–ASA
C–Clopidogrel
C–Cholesterol Lowering “-Statin”
Lovastatin “stay clean”
CAUTION:
NO grapefruit
Liver Toxic–report “clay colored stools”
Muscle pain (Rhabdomyolysis risk)
Late night–take at dinner
CHOLESTEROL
PANEL
C-CLOGGED ARTERIES (risk)
200 or Less-Total Cholesterol
150 or Less-Triglycerides
100 or Less-LDL
40 or More = HDL
Heart Rest:
1st choice A–Ace (-pril) Lisonopril “chill pril”
2nd choice A–ARBs (-sartan) Losartan “relax man”
Antihypertensive (BP ONLY) *HOLD: Low BP (not HR)
Precautions:
A–Avoid Pregnancy
A–Angioedema “thick tongue”
(Airway Risk) *only Ace NCLEX TIP
C–Cough *only Ace
Creatinine (Kidney) (normal: 0.9 -1.2) *only Ace
E–Elevated K+ (normal 3.5-5.0) NCLEX TIP
AVOID Salt Substitues + Green Leafy veggies
• 1st–Cardiac Monitor
• High Potassium = High Pump
• Monitor: muscle cramps, spasms,
peaked T waves, ST changes
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