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NCM118 > Acute MI > Flashcards

Acute MI Flashcards

1
Q

Acute myocardial infarction also called as

A

Heart attack

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2
Q

Occurs when there is a diminished blood supply to the heart which leads to myocardial cell damage and ischemia.

A

MI

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3
Q

stops in the necrotic areas of
the heart.

A

Contractile fx

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4
Q

usually occurs due to blockage of the
coronary vessels.

A

Ischemia

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5
Q

is often the result of thrombus that is superimposed on an ulcerated or unstable atherosclerotic plaque formation in the coronary artery.

A

Ischemia

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6
Q
  • MI’s are described by the area of occurrence.
A

Anterior, inferior, lateral, posterior

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7
Q

MI classification

A

Anatomic
Diagnostic

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8
Q

Anatomic

A

Transmural
Subendocardial

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9
Q

Diagnostic

A

ST Elevation (STEMI)
Non ST Elevation (Non STEMI)

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10
Q

Non modifiable risk factors

A

Age
Gender
Fam hx

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11
Q

Modifiable

A

Smoking
Htn
Dm
Obesity

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12
Q

S/sx

A

Chest pain
Nausea and vomiting
Cardiovascular changes

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13
Q

The most common initial manifestation

A

Chest pain

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14
Q

PQRST assessment

A

Precipitating events
Quality of pain
Radiation of pain
Severity of pain
Timing

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15
Q

results as a reflex from severe pain.

A

Vomitng

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16
Q

reflexes initiated from area of ischemia.

A

Vasovagal reflexes

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17
Q

Cardiovascular changes

A

Initial, increase BP and pulse
Later, decrease bp
Decrease Urine output
Crackles
Distended jugular vein
Obvious pulse

18
Q

First 10 minutes

A

Check vs and o2
Establish Iv access
Obtain and review 12 lead ECG
Take brief hx and perform PE
Obtain bld samples: initial cardiac markers, electrolytes, coagulation

19
Q

Dx

A

ECG confirm MI
12 lead ECG distinguish STEMI and NONSTEMI

20
Q

produce certain proteins and enzymes associated with cellular functions.

A

Myocardial cells

21
Q
  • When cell death occurs, these cellular enzymes are released into the blood stream.
A

CPK and TROPONIN

22
Q

CPK

A

Creatine Phosphokinase

23
Q

Cpk begins

A

rise 3 to 12 hours after acute MI.

24
Q

CPK peak

A

In 24 hrs

25
Q

CPK return to normal

A

2-3 days

26
Q

Myocardial muscle protein

A

Troponin

27
Q

When troponin released

A

After injury

28
Q

High specific indicator of MI

A

Troponin

29
Q

Elevation of troponin

A

2 wks

30
Q

Treatment

A

Immediate goal:
Restore bld flow to vessels
Salvage myocardium

31
Q

General tx

A

MONA

32
Q

Indicated for patients with STEMI MI’s.

A

Fibrinolytic therapy

33
Q

Fibrinolytic therapy when given

A

12 hrs of sx onset

34
Q

will break down clots found
within the vessels

A

Fibrinolytic

35
Q

Contraindications of fibrinolytic therapy

A

Post op surgery
Pregnancy
Ulcer disease
Hx of hemorrhagic stroke

36
Q

A diagnostic angiography which includes
angioplasty and possible stenting.

A

Cardiac catheterization

37
Q

Surgical treatment where saphenous vein is harvested from the lower leg and used to bypass the occluded vessels.

A

Coronary artery bypass graft

38
Q

Long term care

A

Smoking cessation
Aspirin, beta blockers, clopidogrel indefinite
Lipid lowering meds c diet mod

39
Q

Nsg interventions

A

O2 adm
Nitroglycerin adm
Assess signs if ischemic pain
Avoid valsalva maneuver
Stop smoking
Control HTN and DM
Reduce wt

40
Q

Nursing interventions for a patient with acute MI focus on:

A

*Balance myocardial oxygen supply and demand through oxygen administration and vasodilators (e.g., nitroglycerin).
*Monitor for early ventricular dysrhythmias.
*Assess for signs of ischemic pain to prevent complications.

41
Q

Understand acute MI and symptoms like

A

chest pain or pressure.
Inform nurses of any chest pain changes.
Avoid the Valsalva maneuver.
Modify risk factors:
*Fat intake < 30% of calories.
*Cholesterol < 200 mg/dL, LDL < 70 mg/dL.
*Stop smoking, reduce salt.
*Control hypertension, diabetes.
*Increase activity, reduce weight.

NCM118 (23 decks)

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