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ACS/Angina/MI

QuestionAnswer
Unstable angina Partial rupture of an artery, does not cause permanent damage to heart
STEMI classic heart attack, extensive damage to heart. ST elevation
NSTEMI intermediate form of ACS. causes less extensive damage to heart. ST depression, T inversion
ACS assessment Chest pain, SOB, "impending doom", tachycardia, hypotension, decreased GU, fever, "elephant in chest". Less apparent in women
Troponin 1 and Troponin T Peaks within 24-48 hours and can remain elevated for days. 3 negative troponins = discharge
Creatine kinase-MB (CK-MB) Peaks by 24 hours. Returns to normal within 48-72 hours. Useful in detecting re-infarction in clients
ACS management Monitor I&O and tissue perfusion, tele monitor, EKG before meds
ACS medications Clopidogrel, aspirin, metoprolol, morphine, nitroglycerin, heparin
ACS clopidogrel 300mg. Prevents arterial clots
ACS aspirin Prevents vasoconstriction
ACS metoprolol May not be needed in initial management. Prescribed within 24 hours of admission
ACS morphine Reduced pain and anxiety. Caution in asthma, emphysema clients
ACS nitroglycerin Prevents coronary artery vasospasm, reduces preload/afterload = decreases myocardial oxygen demand. Continuous cardiac and BP monitoring
ACS heparin Prevents clots. Therapeutics range = 60 - 80 PTT. Separate IV from nitroglycerin. Antidote is protamine sulfate
PCI (percutaneous coronary intervention) Balloon to open up artery. Preferred initial treatment. Door to balloon time is 90 minutes.
PCI post-procedure Lay flat for 2-6 hours. Femostop to compress artery (before and after sheath removal). Monitor for bleeding, hematoma
Created by: Haydenmeh
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