Disorders of the Heart Muscle Flashcards
What the medical definition of a myocardial infarction?
When insufficient oxygen supply kills myocardial tissue; may be sudden or gradual (3-6 hours)
What is the etiology/cause of myocardial infarction?
atherosclerotic plaque causes narrowing in the arteries (CAD); sudden rupture of plaque causes thrombotic event; sudden worsening of stenosis, or occluding coronary blood flow to heart muscle
What are the risk factors for a myocardial infarction?
Smoking, obesity, diabetes, sedentary lifestyle, hyperlipidemia, physical/emotional stress, and depression
What are the signs and symptoms of an MI?
Crushing substernal chest pain, pain that may radiate to the left arm, jaw, neck, and/or shoulder blades, pain that doesn’t resolve with rest, and mild indigestion
What is the classic finding of an MI?
Crushing, substernal chest pain
What are clues suggesting a silent MI?
Change in mental status, unexplained abdominal pain, dyspnea, and fatigue
How do you diagnose a MI?
ECG (12-lead, watching ST segments), history/physical, serum markers (elevated troponin & creatinine kinase)
What two serum results are elevated with a MI patient?
Troponin (up to two weeks) & Creatinine Kinase (3-4 days)
How does a nurse manage a suspected or confirmed an acute MI attack?
Vital signs, 12-lead ECG, MONA, and induced hypothermia (returns circulation)
What procedures will be performed for a patient with a MI to help return normal blood flow?
Cardiac catheterization, stent insertion, percutaneous transluminal coronary angioplasty (PTCA), tPA therapy (dissolve the clot), and coronary artery bypass graft surgery
What is the therapeutic treatment for an MI? What is the mnemonic?
OH-BATMAN: oxygen, heparin, beta blockers, aspirin, thrombolytics, morphine, ACE, nitroglycerin
What should the nurse monitor to prevent heart failure, infections, and complications for a MI patient?
Temperature, daily weights, intake & output, respiratory rate, breath sounds, blood pressure, ECG readings, peripheral pulses, and listen for heart sounds (S3 & gallop)
And what is the cardiac care mnemonic?
ABCDEF: ADL’s, Bed rest, Commode, Diversions, Elevate, Feelings
What are the nursing interventions for a patient with MI?
Monitor chest discomfort, monitor for pulmonary edema (cough, tachypnea, crackles), apply antiembolism stockings, and assist with ROM exercises
Nurses should reinforce client and family teaching regarding what with a patient with a MI?
Nitroglycerin use for repeated symptoms and when to seek care; teach the client to report typical and atypical symptoms; gradual resumption of sexual activity; how to look for post-myocardial infarction syndrome; modify lifestyle behavior; change diet if necessary
When can a client with a MI return to normal sexual activity?
When they can walk up two flights of stairs without any symptoms
What is heart failure?
When your heart fails to pump enough blood to support the body’s functions, leading to poor cardiac output and fluid overload
Heart muscle damage is also known as what?
cardiomyopathy
What are the two different types of left sided heart failure?
Systolic heart failure and diastolic
What happens in systolic heart failure?
The left ventricle has a reduced ability to contract
What happens in diastolic heart failure?
The left ventricle is unable to rest properly during diastole , which prevents adequate filling of the left ventricle
What are the signs of left sided heart failure?
Fatigue, cough, weight gain, shortness of breath, orthopnea, tachypnea, crackles, S3 heart sound, pulmonary edema
What are the signs of pulmonary edema?
frothy pink spots, restlessness, irritability, hostility, anxiety, crackles in lungs, diaphoresis, cyanosis
What are the signs of right sided heart failure?
weight gain, jugular vein distention, bilateral dependent edema, liver engorgement, and ascites
