Acute Coronary Sydrome And Stroke Flashcards
ECG Electode Placement: where does RA, RL, LA and LL leads go?
RA - right arm
RL - right leg
LA - left arm
LL- left leg
ECG Electode Placement: V1?
Right side. 4th rib. Just right of medial-sternum.
ECG Electode Placement: V2
Opposite V1
4th rib. To left of medial-sternum.
ECG Electode Placement: V3?
5th rib. Next to V2. Before midclavicular line.
ECG Electode Placement: v4
Left midclavicular line on 6th rib.
ECG Electode Placement: V5.
Between midclavicular line and madaxillary line.
ECG Electode Placement: v6
Midaxillary line.
What is a cardiac arrhythmia?
Irregular HR when electrical signal of the heart doesn’t work properly. Can cause slow HR. Fast HR. Or irregular.
Types of cardiac arrhythmia?
AF atrial fibrillation
Aftrial flutter.
Supraventricular tachycardia SVT
VT ventricular tachycardia
VF Ventricular fibrillation
When measuring a ECG look at:
Rate
Rhythm
P Wave
P/QRS relationship
PR interval
QRS complex
T Wave
Acute Myocardial Infarct (AMI) is?
Blocked blood vessel and threatens damage to heart muscle and function.
What is a STEMI?
Most serious.
Complete blockage of major coronary artery.
What is NSTEMI?
Partial blockage of coronary artery.
What is angina?
Causes by decreased blood flow to the heart.
What is unstable angina?
Accelerating pattern of chest discomfort, more dangerous than angina due to changing severity in partial coronary artery blocks.
Symptoms of Acute Coronary Syndrome
Chest pain that is suddenly and continued despite rest and medications (NG spray)
SOB
Indigestion
Nausea
Anxiety
^ RR
^ HR
Cold skin that is pale and moist
Clinical AX for suspected Acute Coronary Syndrome?
Vitals
12 lead ECG
Pathology - including serial cardiac enzymes, bio markers (myoglobin, troponin, creative kinase)
What is Takostuba Cardiomyopathy? And symptoms of it?
Broken Heart Syndrome.
Caused by a stressful event and Mimics MI with Acute onset chest pain with ST elevation in precordial leads on ECG
What is a CVAD?
Central Venous Access Device
What vein do CVADs go in?
Subclavian or jugular veins.
Why do pt’s get CVADs?
Provide direct venous access.
Most commons CVADs?
PICC line
What to think about with a CVAD Dx change?
Direct access to blood stream so ⬆️ potential for infection.
PICC line care steps:
ANTT
2 min hand wash
Sterile field
Clean site with 2% ETOH chlorhexidine from site outwards in concentric circles.
Allow to air dry ⬆️30 secs.
PICC flush:
ANTT
2 min hand wash
Sterile field
Clean site with 2% ETOH chlorhexidine from site outwards in concentric circles.
Allow to air dry ⬆️30 secs.
Use at least 10 mls syringe with normal saline.
Clamp under pressure
Can be ETOH locked - prevent infection
Or Heparin flushed.
PICC Dx change freq.
Weekly if occlusive Dx or PRN
Daily if gauze. Or PRN
What is a Porta Cath?
Implanted venous access device that empties into central vein, can be access subcutaneously via non-boring needle. Can be single or dual port.
2 types of stroke?
Ischaemic
Haemorrhagic
What is an ischemic stroke?
Inadequate blood flow to the brain due to occlusion of an artery
What is haemorragic stroke?
Bleeding in the brain tissue
What is a TIA
Trans ischemic attack
Nursing consideration for stroke pt:
Ask FAST
Quick primary survey (ABC)
Rapid Response
Neuro exam
If possible position pt on side with bed rails up if unable to sit up.
If sit up. Put bed at 30•
Admin O2
Ensure IV
Neurological assessment: COWS:
Can you hear me?
Open your eyes
What is your name?
Squeeze my hands
Neurological assessment: AVPU
Alert
Voice
Pain
Unresponsive
