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110_Cardiac > Angina and MI > Flashcards

Angina and MI Flashcards

1
Q

CAD (Coronary Artery Disease) Meds

A

Cholestrol meds ezetimibe (Zetia)
Robostatin
Aspirin
Statin
Given at night. Body at rest. Artery are hardened

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2
Q

Angina

A

Coronary Spasm
Not true MI

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3
Q

Chronic Angina

A

intermittent chest pain (on/off)
Resting disappears
Walk & Activity appears

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4
Q

Qn to ask

What is the presipitation of your pain

A

PQRST
P = Provoking factors - what precipitated the pain?
Q = Quality
R = Region (arm/leg)
S = Severity of Pain
T = Timing of Pain

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5
Q

Best indicator of MI

A

Troponin

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6
Q

Prinzmetal Angina is

A

Chronic Angina that is
Coronary Artery Spasm with/ without CAD (coronary artery disease)

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7
Q

Drug of choice for Prinzmetal Angina or Chronic Angina

A

Diltiazem

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8
Q

Drugs for Prinzmetal Angina

A

CCB + Nitro (SL) + Beta blockers

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9
Q

BP high give

A

Amlodipine (Norvosac)
Amlodipine (Norvasc) is one of the first-choice medication options for treating high blood pressure. Additionally, amlodipine (Norvasc) is also a top-choice medication for treating CAD.

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10
Q

Nursing intervention MI

A

Position Patient semi-flowers position

Normal cause of ischemia is lack of oxygen
chest pain = no oxygen = sit patient = pt able to breathe better

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11
Q

1 cause of chest pain is

A

blockage

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12
Q

1 thing to do

A

Apply O2

Ischemia is #1 cause = No oxygen in part of heart

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13
Q

Med for for Chest Pain

A

ONAM
Apply O2
Nitro
Aspirin
Morphine

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14
Q

Drug of choice for chest pain

A

Morphine lessens cardiac workload

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15
Q

Nursing Interventions for MI

A

EKG
Chest X-ray to know heart or lung problem
Troponin
CRP
Electron Beam Tomography
Exercise Stress Test
Coronary Computed Tomography Angiography

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16
Q

Before Angiography
Patient Teaching before
Cardiac Catherization «Test»

A

Check for Iodine Allergy
Avoid Metaformin
Renal function test
Teach you will feel flushing = warmth > flash>jumping ###exam

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17
Q

Gold Standard to remove heart blocks

A

Cardiac Catherization

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18
Q

CABG

A

less intervention

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19
Q

PCI (Percutaneous Coronary Intervention) Assess

A

> Check allergy
Base line Vital Sign = BP normal
give metoprolol for increased BP.
Check pulse ox, HR, RR
Labs: Troponin, CBC, Hgb/Hct
In stenting = lot of blood is lost
Administer drugs
Pt education post procedure

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20
Q

CAD (Coronary Artery Disease)
2 sub divisions

A
  1. Chronic Stable Angina
  2. Acute Coronary Syndrome (ACS).
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21
Q

Chronic Stable Angina can become

A

Acute

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22
Q

ACS = 2 subdivision

A
  1. NSTEMI - Unstable Angina Non-ST segment eleveation MI
  2. STEMI -ST- Segment Elevation MI
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23
Q

Unstable Angina is the same as

A

NSTEMI

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24
Q

With ST elevation

A

Troponin elevation greater than 0.5

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25
Q

ACS == Unstable Angina

A

New Onset

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26
Q

Tx unstable angina

A

Thrombolytic administered within 6 hours of start of chest pain.

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27
Q

ACS = Myocardial Infaraction (MI)

A

You have the blockage, and it is not complete blockage

28
Q

Ask Pt history?

A

Hx of CAD, Preexisitng genetic condition

29
Q

STEMI occlusive thrombosis means ST elevation which can lead to

A

infarctions

30
Q

treatment for STEMI

A
  1. Artery must be open with
    PCI within 12 to 72 hours
  2. Thrombolytic to be administered
31
Q

2 types of blocks

A
  1. Occlusive
  2. Non-occlusibe
32
Q

STEMI or NSTEMI Rule

A

Fix it within 90 mins

33
Q

Sign of MI

A

Chest pain occurs early in the morning greater than 20 mins

34
Q

No pain if

A

cardiac neuropathy
Note : diabetes they have pain

35
Q

With MI intially and then

A

Initially HR high trying to compensate, then stops.

36
Q

S/s of MI

A

Initially HR high
BP low
Juglar vein distention
Abnormal HR

37
Q

If BP = 90/70

A

I am giving fluids to increase cardiac output

38
Q

MI = Hypotensive = cardiac o/p low so —-

A

Renal o/p low. Oliguria, BUN high
Heart is not pumping to perfuse kidney

39
Q

Carida output problem is the

A

Kidney problem

40
Q

Clinical Manifestations of MI
(4)

A

1 N&V
2. Increase temp with injury to the heart with MI
3. Heaviness = SOB - feels like elephant sitting on chest

41
Q

Mi leads to

A

v-fib (dysrhythmias)
Heart is trying to compensate V-fib/ V-tach

42
Q

MI complication is

43
Q

Complication of MI

A

Dysrhythmias
LHF = Pulmonary Edema (water in the lungs)
RHF = Edema all over the body.

44
Q

Main Complication of MI

A

Cardiogenic Shock
Decreased oxygen and nutrients to the heart
Fast Pulse, HR increased, RR increased
Eventually everything will go down BP low

45
Q

In all shocks = septic, stroke shock cardiogenic shock

46
Q

MI = Cadiogenic shock then

A

Intubate the pt./ no perfusion in lungs
Prevent VAP = Turn, Cough, Deep Breathe
While suctioning with catether = no suction while inserting, and then suction on taking out fast.
Hyperoxygenate the pt. first

47
Q

ACS Diagnostic Studies

A

Always choose 12-lead EKG (STEMI/ NSTEMI observed)
Lab Troponin high
Electrolytes abnormal

Draw troponin every 8 H - cardiac biomarkers
EKG every 24 H

48
Q

Problem detected MI (Troponin high)

A

Cardiac Catherization is done within 90 mins for STEMI and need PCI or CABG as per pt. confition

49
Q

Nursing Care and Interprofessional Care
ACS (Acute Coronary Syndrome)

A

Pt. semi-flowers or flowers position,
Put oxygen
2 IV in pt with MI
Give medication ONAM, then statin

50
Q

Unstable Angina = NSTEMI medication

A

(1) Give Heparin which is not a thromobyltic bit an anticoagulant

Thrombolytics are clot buster or dissolves
Anticoagulant are blood thinner or prevents clots

(2) Glycoprotein lob/ IIIa inhibitors

51
Q

ACS interprofessional care

A

Remember table in your text

52
Q

Chronic = not ICU

A

Acute = ICU = Continuous EKG

53
Q

All MI Bed Rest

A

Pee in Bed, Eat in Bed
NOT WALKING # Bed rest for MI

54
Q

Check
Interprofessional Mgmt

A

Heparin - UA & NSTEMI
DAPT = NSTEMI and UA with stent
Aspirin UA
Cardiac catherization = Reperfusion = STEMI = Thrombolytic Therapy

55
Q

Evaluation for STEMI

A

Neuro, Pupils, the way they move

56
Q

MI STEMI

A

Administration of IV within 30 mins of arrival

57
Q

STEMI

A

Thromobolytic therapy - available and rapid administration if not PCI capable. or Give meds awaiting for PCI

58
Q

Acute treatment

A

1st treatment for acute MI is
PCI
Goal open block heart = oxygenation and perfusion into heart.
Give nitro drip = vasodilation BP falls= hypotension - headache = dilation

59
Q

Thormbolytic thearpy Caution

A

Pt will bleed. Get
Hemostat Gauze, do blood work before for coagulation panel Plt, aPTT and PTT.

60
Q

Thrombolytic Therapy done for

A

Chest Pain less than 12 hours
12 Lead KKG shows STEMI
No absolute blood dyscrasia/ hemophilia <Table 33-15>

61
Q

repurfusion after Heart Attack

A

ST segment returns to baseline.
PCI done - we have reperfusion
Heart is back
No check pain
Rapid rise fo serum bio markers - peak within 12 hours
Reperfusion dyrhytjmisa less reliable indicator.

62
Q

Scaring of heart

A

1st degree heart block/ PAC/ Ventricular Cardiac arrhythmias

63
Q

Major concern after HA

A

Reocclusion, so give
IV Heparin
Monitor chest pain and
ECG changes

64
Q

Major complication of Heparin

A

Bleeding dafety alert
s/s of bleeding complication:
- abdominal pain
- Check for blood in urine and BM
- blood in eyes, ear, and lungs

65
Q

Meds for ACS

A

Ace Inhibitors
Norvac (Amlodapine)
Verapamil
Antidyrrhythmic drugs
colase
lipid-lowering drugs (statins)
stool softner

110_Cardiac (8 decks)

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