Circulation and Perfusion Flashcards
Myocardial Infarction, MI, heart attack
ischemia and necrosis of myocardial tissue often related to a thrombus blockage of a coronary vessel
death of heart tissue caused by lack of oxygenated blood flow
What is a thrombus?
blood clot
What is a thromboembolism?
obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation
What is a STEMI?
St segment elevation
An ST-elevation myocardial infarction (STEMI) is a type of heart attack that is more serious and has a greater risk of serious complications and death. It gets its name from how it mainly affects the heart’s lower chambers and changes how electrical current travels through them
What is a NSTEMI?
A non-ST-elevation myocardial infarction (NSTEMI) is a type of heart attack that usually happens when your heart’s need for oxygen can’t be met. This condition gets its name because it doesn’t have an easily identifiable electrical pattern (ST elevation) like the other main types of heart attacks
What is a pulmonary embolism?
a blood clot gets stuck in an artery in the lung, blocking blood flow to part of the lung
medical tx of PE
anticoagulant therapy
LMW heparin
Nursing Management PE
medication, monitor liver function when receiving anti coagulants Semi fowlers, elevate HOB, analgesics for pain if needed, managing oxygen therapy
Assessment for ACS
chest pain (occurs suddenly and continues despite rest and medication
s/s sob, c/o indigestion, nausea, anxiety, cool, pale skin, increased HR, RR
ECG changes elevation in the ST segment in two contiguous leads is a key diagnostic factor for MI
nursing interventions ACS
relieve pain and s/s of ischemia
improve respiratory function
promote tissue perfusion
reduce anxiety
educate pt and family
provide continuous care
what is ischemia
reduced blood flow (remember there is oxygen in blood)
drugs for increased heart rate
beta blockers, calcium channel blockers
drugs for increased blood volume (preload)
beta blockers, nitrates, calcium channel blockers
drugs for increased blood pressure (afterload)
beta blockers, nitrates, calcium channel blockers
drugs for increased muscle contractility
beta blockers, calcium channel blockers
what is a beta blocker?
Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. Beta blockers cause the heart to beat more slowly and with less force, which lowers blood pressure. Beta blockers also help widen veins and arteries to improve blood flow
What is a calcium channel blocker?
prevent calcium from coming into the myocardial cell membrane, causes dilation of coronary and peripheral arteries
no calcium = dilation
how does calcium affect the heart?
Calcium particles enter the heart muscle cells during each heartbeat and contribute to the electrical signal that coordinates the heart’s function. Calcium particles also bind to machinery within the cell that helps the cell to squeeze together (contract), which makes the heart pump blood.
Nitrates / Nitroglycerin
acts directly on the smooth muscle to cause relaxation and depress muscle tone
prevent and tx of attacks of angina pectoris
Help restore the appropriate supply-and-demand ratio in oxygen delivery to the myocardium when rest is not enough
Nitrates work as venodilators and arterial dilators, and by these actions in patients with angina pectoris can reduce myocardial oxygen demands while maintaining or increasing coronary artery flow. On the cellular level, they may increase endothelial prostacyclin release to cause their vasodilating effects
what is mitral valve prolapse?
Improper closure of the valve between the heart’s upper and lower left chambers
what is mitral stenosis?
a narrowing of the heart’s mitral valve
what is aortic regurgitation?
condition that occurs when your heart’s aortic valve doesn’t close tightly as a result blood can leak backwards
what is a stroke?
“brain attack”
sudden loss of function resulting from a disruption of the blood supply to a part of the brain
ischemic stroke
Disruption of the blood supply caused by an obstruction, usually a thrombus or embolism, that causes infarction of brain tissue
Hemorrhagic Stroke
too much blood in the brain
What are anticoagulants?
reduce the ability of the blood to clot
what are antiplatelets?
alter the formation of the platelet plug
what is a thrombolytic drug?
breakdown the thrombus that has been formed by stimulating the plasmin system
Antiplatelets
Abciximab (ReoPro)
Anagrelide (Agrylin)
Aspirin (generic)
Cilostazol (Pletal)
Clopidogrel (Plavix)
Dipyridamole (Persantine)
Eptifibatide (Integrilin)
Ticagrelor (Brilinta)
Ticlopidine (generic)
Tirofiban (Aggrastat)
Vorapaxar (Zontivity)
Anticoagulants
Antithrombin III (Thrombate III)
Argatroban (Acova)
Betrixaban (Bevyxxa)
Bivalirudin (Angiomax)
Desirudin (Iprivask)
Fondaparinux (Arixtra)
Heparin (generic)
Warfarin (Coumadin)
Dabigatran (Pradaxa)
Rivaroxaban (Xarelto)
Apixaban (Eliquis)
Edoxaban (Savaysa)
Protein C concentrate (Ceprotin)
Thrombolytic meds
Break down the thrombus that has been formed by stimulating the plasmin system
Alteplase (Activase)
Reteplase (Retavase)
Tenecteplase (TNKase)
Urokinase (Abbokinase)
what is atherosclerosis?
abnormal accumulation of lipid, or fatty substances and fibrous tissue in the of the arterial blood vessel wall
what is myglobin?
earliest marker of injury to cardiac/skeletal muscle
what is troponin?
positive value indicates damage to cardiac tissue and should be reported
what is preload?
ventricular filling
what is afterload?
the amount of pressure that the heart needs to exert to eject the blood during ventricular contraction
what is heart failure?
when heart muscle is unable to pump effectively resulting in inadequate cardiac output, myocardial hypertrophy and pulmonary/systemic congestion
