Acute MI

Question 1

Acute myocardial infarction also called as

Answer 1

Heart attack

Question 2

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

Answer 2

MI

Question 3

stops in the necrotic areas of
the heart.

Answer 3

Contractile fx

Question 4

usually occurs due to blockage of the
coronary vessels.

Answer 4

Ischemia

Question 5

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

Answer 5

Ischemia

Question 6

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

Answer 6

Anterior, inferior, lateral, posterior

Question 7

MI classification

Answer 7

Anatomic
Diagnostic

Question 8

Anatomic

Answer 8

Transmural
Subendocardial

Question 9

Diagnostic

Answer 9

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

Question 10

Non modifiable risk factors

Answer 10

Age
Gender
Fam hx

Question 11

Modifiable

Answer 11

Smoking
Htn
Dm
Obesity

Question 12

S/sx

Answer 12

Chest pain
Nausea and vomiting
Cardiovascular changes

Question 13

The most common initial manifestation

Answer 13

Chest pain

Question 14

PQRST assessment

Answer 14

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

Question 15

results as a reflex from severe pain.

Answer 15

Vomitng

Question 16

reflexes initiated from area of ischemia.

Answer 16

Vasovagal reflexes

Question 17

Cardiovascular changes

Answer 17

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

Question 18

First 10 minutes

Answer 18

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

Question 19

Dx

Answer 19

ECG confirm MI
12 lead ECG distinguish STEMI and NONSTEMI

Question 20

produce certain proteins and enzymes associated with cellular functions.

Answer 20

Myocardial cells

Question 21

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

Answer 21

CPK and TROPONIN

Question 22

CPK

Answer 22

Creatine Phosphokinase

Question 23

Cpk begins

Answer 23

rise 3 to 12 hours after acute MI.

Question 24

CPK peak

Answer 24

In 24 hrs

Question 25

CPK return to normal

Answer 25

2-3 days

Question 26

Myocardial muscle protein

Answer 26

Troponin

Question 27

When troponin released

Answer 27

After injury

Question 28

High specific indicator of MI

Answer 28

Troponin

Question 29

Elevation of troponin

Answer 29

2 wks

Question 30

Treatment

Answer 30

Immediate goal: Restore bld flow to vessels Salvage myocardium

Question 31

General tx

Answer 31

MONA

Question 32

Indicated for patients with STEMI MI's.

Answer 32

Fibrinolytic therapy

Question 33

Fibrinolytic therapy when given

Answer 33

12 hrs of sx onset

Question 34

will break down clots found within the vessels

Answer 34

Fibrinolytic

Question 35

Contraindications of fibrinolytic therapy

Answer 35

Post op surgery Pregnancy Ulcer disease Hx of hemorrhagic stroke

Question 36

A diagnostic angiography which includes angioplasty and possible stenting.

Answer 36

Cardiac catheterization

Question 37

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

Answer 37

Coronary artery bypass graft

Question 38

Long term care

Answer 38

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

Question 39

Nsg interventions

Answer 39

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

Question 40

Nursing interventions for a patient with acute MI focus on:

Answer 40

*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.

Question 41

Understand acute MI and symptoms like

Answer 41

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.