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N126-U3-I. MI/CHF #2
Dobrisky-Cardiac Module: Management of acute MI
| Question | Answer |
|---|---|
| What are the goals of treatment of acute MI? | Limit infarct size, prevent and recognize complications. |
| How is survival increased by the use of thrombolytic therapy? | clots are dissolved |
| What affect does thrombolytic therapy have on the infarct size? | decreases infarct size |
| What affect does decreasing infarct size have on ventricular function? | increases ventricular function |
| Why is morphine sulfate used to treat acute MI? | decreases pain, decreases BP, vasodilates, decreases workload of the heart |
| What affect does morphine sulfate have on BP? | decreases |
| Is morphine sulfate a vasodilator or vasoconstrictor? | Vasodilator |
| What do beta-adrenergic blocking agents & calcium channel blockers have in common in the treatment of acute MI? | slows heart rate, increase coronary perfusion and decrease oxygen demand |
| What affect do beta blockers have on contractility? | decrease |
| What affect do calcium channel blockers have on preload and afterload? | decrease |
| Which drub, beta blocker or calcium channel blocker, decreases the remodeling of the left ventricle? | calcium channel blocker. |
| Which drug decreases contractility? | beta blockers |
| How do ACE inhibitors help the cardiac muscle? | decrease oxygen demand and preload. |
| Which medication decreases oxygen demand and preload? Calcium channel blockers, ACE inhibitors or Beta blockers? | Ace inhibitors |
| What affect do anticoagulants have on patients with acute MI? | prevent the growth of a thrombus |
| When using anticoagulants what should a nurse observe for? | bleeding |
| what labs should a nurse monitor during anticoagulant therapy? | HB, HCT, platelets, PT/INR and PTT. |
| What trend should a nurse report when monitoring HB, HCT and platelets? | a decrease |
| What is the role of antiplatelet agents? | inhibits thromboxane-induced platelet aggregation. |
| Antiplatelet agents inhibit ______________ platelet aggregation. | thromboxane-induced |
| When chest pain first begins what medications should be given to the patient? | Nitroglycerin and aspirin |
| Nitroglycerin should be given how many times to rule out angina? | three |
| What mg of aspirin should be given? How should it be administered? | 325mg, PO, chewed |
| An increase in oxygen demand by the myocardium makes what therapy essential during an MI? | oxygen |
| Oxygen is essential because of what affect on the myocardium? | preservation |
| Name 3 ways to ease the pain of an MI. | nitroglycerin, morphine sulfate and rest with oxygen. |
| How should the nitroglycerin be administered? | sublingually |
| How should morphine sulfate be administered? | IV |
| What activity level is necessary during an MI? Why? | Bedrest. to decrease the workload on the heart. |
| A patient is placed on telemetry to monitor for what? | changes in heart rate & rhythm |
| What type of diet is usually ordered for an MI patient? | low sodium, low cholesterol |
| Why is it important to limit sodium intake? | to decrease fluid retention resulting in a decreased workload on the heart |
| Why is it important to decrease cholesterol in the diet? | to prevent buildup of atherosclerosis in the arteries. |
| What are priority nursing actions in the post acute phase of MI? | ongoing assessments, ECG monitoring, O2 sat levels, ABGs |
| How does the patient's activity level change in the post acute phase of an MI? | slowly increase activity while assessing vital signs, O2 sats and fatigue level. |
| What are priority nursing actions in the early acute phase of MI? | morphine, oxygen, nitroglycerin, aspirin |
Created by:
Lori Dobrisky
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