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Cardiac Nursing

Immediate Treatment for an Acute MI MONA Morphine, O2, Nitroglycerine, ASA
3 Areas of Damage after MI Injury, Ischemia, Infarction
Infarction O2 deprived, irreversible damage, Q-wave on EKG, Transmural
Injury- MI Tissue viable if circulation remains adequate, Increasing O2 may save this area, S-T segment elevation on EKG
Ischemia MI Tissue may be viable and may not be damaged as long as MI is ended and provided collateral circulation can compensate, depressed S-T on EKG
Beta Blockers Usually end in OLOL, Block Beta Receptors in Heart (SNS) so decreases HR, Contractile Force, Rate of A-V conduction
Beta Blocker Side Effects Bradycardia, lethargy, GI disturbance, CHF,Decrease BP, Depression
Beta Blocker Names Atenolol (Tenormin), Propanolol (Inderol), Metoprolol (Lopressor)
Ace Inhibitors Decrease peripheral vascular resistance without increasing CO, HR, Contractility
Ace Inhibitor Side Effects Dizziness, Orthostatic Hypostension, GI Upset, Cough, Headache
Ace Inhibitor Names Captopril (Capoten), Enalapril (Vasotec), Benazpril (Lotensin)
Bradycardia And Drugs to Lower BP Isoproterenol, dopamine, Epinepherine, Atropine
Calcium Channel Blockers Block Calcium Access to Cells
Ca Channel Blocker Action Decrease Contractility, Decrease Conductivity of Heart, thus decreasing Demand for O2
Calcium Channel Blocker Side Effects Decrease BP, bradycardia, may precipitate A-V Block, Headache, Abdominal Discomfort (constipation, nausea), Peripehral Edema
Calcium Channel Blocker Names Verapamil, Nefedipine, Diltiazem (Very Nice Drugs mnemonic)
Beta 1 Blockers These beta blockers affect the heart
Beta 2 Blockers These beta blockers affect the lungs
Cardiac Enzymes CK/CPK, CK-MB, Myoglobin, Troponin, AST, LDH
CK/CPK Onset of Elevation (3-6 hours), Peak (10-30 hours) Return to baseline (3-4 days)
CK-MB Onset of Elevation (4-8 Hours), Peak (12-24 Hours), Baseline Return (3 days)
Myoglobin Onset of Elevation (2-6 hours), peak (8 hours), baseline (12-18 hours)
Troponin Onset of Elevation (1-5 hours), peak elevation (14-21 hours), baseline 7 days
AST Onset of Elevation (6 hours), Peak (12-14 hours), Baseline (4 days)
LDH Onset of Elevation (24-48 hours), Peak Elevation (3-6 days), Baseline 14 days
CK/CPK Does not elevate with CHF, Angina, PE
Myoglobin Released into circulation after injury, Used for early dx of MI (values double w/in 2 hours after onset of chest pain in acute MI) This lab is drawn when pt presents with chst pain and then in 2 hours.
Troponin Values greater than 1.5ng/ml Indicates Myocardial damage, Normal values do not rule out MI, values increase as early as one hour after onset of chest pain
Aspartate Aminotransferase (AST) Not necessarily specified for MI, when used in conjunction with CK-MB and LDH timing of MI can be predicted
LDH (lactic dehydrogenase) If LDH 1 > LDH 2 then positive for acute MI
BNP Stored in Ventricular myocardium, Levels increase with diastolic pressure increases. Elevated in CHF, Ventricular Hypertrophy, Severe HTN
ASA- During MI 324mg
ASA- Maintainence Dose 324mg
ASA- prophylactic Dose 81mg
Nitroglycerine Action Increase BF and stimulates blood flow to coronary artery, contraindicated in those using viagra as both vasodilate and could cause fatal hypotension and heart collapse
Morphine- action in MI decrease pain, bronchodilates to lessen MI dramatically
Beta Blocker in MI Standard unless BP extremely low then hold
Vasopressors- in heart disease Casise vasoconstriction to increase pressur in severe hypotension
Transmural MI Q-wave present, entire thickness is affected, often affects left ventricle, compromises cardiac efficiency
Non-Transmural MI Non-Qwave MI, S-T elevation and or depresion and possible T wave inversion
Created by: troutbaron