Heart

Question 1

Inferior ischemia on the EKG

Answer 1

Inverted T waves in leads II and III

Question 2

MI manifestations

Answer 2

Chest pain, weakness, TIGHTNESS

Diaphoresis, N/V

NOT relieved by nitro and rest

Lasts longer than 30 mins

Can last hours

Question 3

MI in women

Answer 3

More subtle

Pain in abd, shoulder, back

N/V, Dyspnea, diaphoresis, Fainting

Older women may not have pain

Higher mortality due to less obvious manifestations

Question 4

MI in diabetics/elderly

Answer 4

Symptoms may be absent/mild

Question 5

MI interventions

Answer 5

OXYGEN
IV
EKG
Aspirin to chew (quick release)
Notify provider

Pain:

• Nitro
• Morphine

Restore perfusion to injured area via coronary arteries becoming un-occluded

Question 6

Drugs for MI

Answer 6

Glycoprotein inhibitors (anti platelet) 
ex. abciximab

Anticoagulants
ex. Eliquis, warfarin, Xarelto

Beta blockers

Ace inhibitors

Thrombolytics (TNKase, TPA, ___plase)

Ca channel blockers (Amlodipine, Verapamil)

Anti arrhythmics (Amiodarone)

Diuretics

Question 7

Thrombolytic therapy for MI

Answer 7

Fibrinolytics

• TPA
• Reteplase

Give within 3 to 6 hours

Avoid anything that could cause bleeding

Check INR (prothrombin test) and PTT (partial thromboplastin) times

Normal INR: 1.1 and under

Normal PTT: 60-70 seconds

Question 8

Percutaneous Transluminal Coronary Angioplasty (PTCA)

Answer 8

Balloon through femoral artery blown up in coronary artery to compress plaque, stent may be placed.

Question 9

Relationship between low CO and kidneys

Answer 9

Decreased renal perfusion

RAAS cascade stimulated–> INCREASED intravascular volume