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