Quiz 6 Myocardial Infarction Flashcards
Difference between stable and unstable angina:
Stable Angina: Predictable and relieved by nitroglycerin
UNstable Angina: NOT relieved by rest or nitroglycerin, not predictable, and related to MI
What Dx findings would you find for someone who has a confirmed MI?
+ ECG
+ Elevated S -T wave in the ECG
What labs will they run (for someone who has a confirmed MI)?
+ Troponin (cardiac enzyme)
+ 3 sets of troponin labs 6 hours apart, if they all come back positive, this is another means of confirming an MI [they also run CK and CKMB - but the most accurate is troponin labs]
Pathophysiology of an MI:
Impaired blood flow
What is the main cause of impaired blood flow in the arteries of the heart?
Atherosclerosis // built up plaques in the arteries of the heart can cause MI
S/S of an MI:
*Elevated BP* Nausea Vomiting Chest pain relieved with rest SOB (shortness of breath) Referred pain to the let arm Tachycardia Substernal chest pain
What is the primary intervention for a client with chest pain suspected for an MI?
Immediately apply O2 (oxygen)
EKG
What is oxygen or oxygenation expected to do? How would we expect the heart to respond?
Decrease cardiac workload and increase oxygenation to the heart
Evidence that ischemia {lack of oxygen} has improved: What will we see on the ECG/ EKG?
S - T elevation would return to baseline
Pathophysiology of interior wall MI, where is the damage located?
Right Coronary Artery
Discharge teaching for pt who is receiving tx for an MI?
Rest / bed rest
Complication of an MI: What happens as a result of an MI?
Decreased cardiac output
+ Increased cardiac workload because of tissue damage (muscle, artery), it will not perform as normal
What is a PTCA {Percutaneous Transluminal Coronary Angioplasty}? (-plasty = molding, grafting, or forming)
Scrapes the plaque out of the artery and a stent is applied to keep the artery open
What is the goal of a PTCA?
Improve the blood flow and open the artery
What is the nursing dx for a client with MI?
- Impaired or decreased oxygenation* as a result of this you will have myocardial tissue perfusion
- Impaired perfusion is why oxygenation is impaired
What is the priority assessment for a pt receiving thrombolytics (tPA / clot buster)? What are you watching for in these patients?
Bleeding risk
Pathophysiology of a STEMI
Tissue damage / atherosclerosis
Where is the STEMI does the damage occur? What part of the heart will you see damage?
Endocardium and Epicardium
What type of MI involves the complete heart? (All 3 layers)
Transmural MI
What post acute care is usually ordered now for a pt who is discharged after an MI? What type of care is ordered?
Cardiac Rehabilitation (includes different aerobic activities)
S/S of an MI?
*Elevated BP* Tachycardia N/ V SOB Pain in the: Chest pain that is NOT relieved with rest Neck Jaw Left arm Substernal chest
