Acute Coronary Syndrome Flashcards
Describe ACS
severe cardiac ischemia including unstable angina and MI
list the symptoms of ACS
chest pain, tachycardia, dyspnoea, diaphoresis, nausea, cool pale skin, HOTN
explain why chest pain occurs in ACS
ischemia or infarction of myocardial cell activates pain receptors
why does tachycardia occur in ACS
to increase cardiac output and maintain perfusion to vital organs
why does dyspnoea occur in ACS
can be due to anxiety/stress or fluid build up due to reduced cardiac function
why might diaphoresis occur in ACS
SNS is stimulated and tries to regulate body temp
why might HOTN occur in ACS?
due to reduced cardiac function which causes reduced CO
Why might someone have cool pale skin in ACS?
SNS stimulates peripheral vasoconstriction to drive blood towards vital organs as well as reduced CO leaving skin poorly perfused
list four nursing interventions for ACS and provide a rationale for each
1) initiate O2 therapy to increase oxygen supply to myocardium and avoid hypoxia
2) place patient in Fowler’s position to optimise respiratory mechanics and reduce cardiac workload
3) Provide pain relief to improve oxygen demand-supply balance, improve comfort and reduce distress
4) Monitor ECG continuously to gain information on patients condition
how would you evaluate oxygen therapy as a nursing intervention for ACS and provide a rationale
Monitor O2 sats for improvement or maintenance to ensure >92% and RR, HR and BP for improvement or maintenance as O2 therapy should support adequate tissue oxygenation, reduce myocardial workload and improve cardiac function which would reduce need for the CMs
how would you evaluate Fowler’s position in ACS and provide a rationale
Monitor RR for improvement or maintenance and dyspnoea as semi-Fowler’s should optimise lung expansion and reduce cardiac workload monitor SpO2 as Fowler’s can improve ventilation-perfusion matching and enhance gas exchange, potentially leading to improved oxygenation
fill in the blanks for evaluation of Fowler’s
Monitor ____ for improvement or maintenance and _____ as semi-Fowler’s should optimise lung _____ and reduce cardiac _______
monitor _______ as Fowler’s can improve______ matching and enhance ____________, potentially leading to improved oxygenation.
RR, dyspnoea, expansion, workload, SpO2, ventilation-perfusion, gas exchange
fill in the blanks for the evaluation of O2 therapy
Monitor O2 sats for improvement or maintenance to ensure >92% and _____, HR and _______ for improvement or maintenance as O2 therapy should support adequate_________, reduce myocardial workload and improve ________ which would reduce need for the _________
RR, BP, tissue oxygenation, cardiac function, CMs
explain how you would evaluate pain relief as an intervention for ACS
Monitor HR, BP, RR and pain score as effective pain relief will reduce SNS activation and stable vital signs
explain how you would evaluate ECG monitoring as an intervention for ACS
Interpretation of the ECG will allow for a timely diagnosis and initiation of specific treatment to assist with reperfusion as well as identify any arrhythmias which can further impair cardiac output and tissue perfusion
