CCRN Flashcards
What indicates chest pain relief in reperfusion?
Due to fibrinolysis of clot
What does resolution of ~T segment deviations indicate?
Due to return of blood flow
What causes marked elevation of troponin/CK-MB?
Due to myocardial ‘stunning’ when vessel opens
What are reperfusion arrhythmias?
VT, VF, accelerated idioventricular rhythm (AIVR) due to myocardial ‘stunning’ when vessel opens
What should be assessed for in nursing management post-reperfusion?
Major and minor bleeding
What are signs of a major bleed?
Change in LOC, brain bleed
What precautions should be instituted during nursing management?
Bleeding precautions
What should be assessed for in terms of reperfusion?
Reocclusion as evidenced by recurring chest pain, ST deviation
What is the treatment approach for NSTEMI?
No emergent reperfusion, same meds as STEMI
What should be started if there is a high risk score or continued chest pain?
GP IIb/IIIa inhibitors (Integrilin, Reopro) and prepare for diagnostic cardiac catheterization within 24 hours
What is the most common complication of an acute MI?
Arrhythmias
What arrhythmias are commonly associated with acute MI?
Ventricular tachycardia or ventricular fibrillation
What is the treatment for ventricular fibrillation?
Defibrillate VF
What is the drug therapy used for?
Stable, sustained VT and to prevent recurrent VF
What is synchronized cardioversion used for?
Unstable, sustained VT
What are other complications of an acute MI?
Bradycardia, heart blocks, sick sinus syndrome (SSS), atrial fibrillation, heart failure, cardiogenic shock, reinfarction, thromboembolic events, pericarditis, ventricular aneurysm, ventricular septal defect, papillary muscle rupture, cardiac wall rupture
True or False: Atrial fibrillation increases risk of mortality by 10-15%, even when returned to NSR.
True
