P. 1
Cardiovascular

Cardiovascular

|Views: 1,465|Likes:
Published by buzz Q

More info:

Published by: buzz Q on Jul 17, 2008
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PPT, PDF, TXT or read online from Scribd
See more
See less

05/13/2012

pdf

text

original

Diagnostic Evaluation:
Diagnostic Evaluation:
Characteristic of chest pain:
Characteristic of chest pain:
Substernal or retrosternal pain that
Substernal or retrosternal pain that
radiates to arms neck and jaws

radiates to arms neck and jaws
Squeezing, heavy, tightness of the
Squeezing, heavy, tightness of the
chest

chest
Precipitated by cold, eating, emotions
Precipitated by cold, eating, emotions
and exertion

and exertion
Lasts a few minutes and then subsides
Lasts a few minutes and then subsides

Myocardial Infarction

Myocardial Infarction

Diagnostic Evaluation:
Diagnostic Evaluation:
Chest pain can’t be relieved by NTG
Chest pain can’t be relieved by NTG
ST segment depression and T wave
ST segment depression and T wave
inversion

inversion
Cardiac enzymes: increased
Cardiac enzymes: increased
Troponin-T (CT and T)
Troponin-T (CT and T)
CK MB (CREATINE PHOSPHOKINASE)
CK MB (CREATINE PHOSPHOKINASE)
LDH (lactate dehydrogenase)
LDH (lactate dehydrogenase)
AST (aspartate aminotransferase)
AST (aspartate aminotransferase)

CK -MB

CK -MB

it rises in serum within 2 to 8
it rises in serum within 2 to 8
hours of onset of acute

hours of onset of acute
myocardial infarction.

myocardial infarction.
Serial measurements every 2 to
Serial measurements every 2 to
4 hours for a period of 9 to 12

4 hours for a period of 9 to 12
hours after the patient is first

hours after the patient is first
seen will provide a pattern to

seen will provide a pattern to
determine whether the CK-MB is

determine whether the CK-MB is
rising, indicative of myocardial

rising, indicative of myocardial
injury.

injury.
The CK-MB is also useful for
The CK-MB is also useful for
diagnosis of reinfarction or

diagnosis of reinfarction or
extensive of an MI because it

extensive of an MI because it
begins to fall after a day,

begins to fall after a day,
dissipating in 1 to 3 days, so

dissipating in 1 to 3 days, so
subsequent elevations are

subsequent elevations are
indicative of another event.

indicative of another event.

Myocardial Infarction

Myocardial Infarction

Nursing Diagnosis:
Nursing Diagnosis:
Pain related to an imbalance in oxygen
Pain related to an imbalance in oxygen
supply and demand

supply and demand
Anxiety related to chest pain, fear of
Anxiety related to chest pain, fear of
death and threatening environment

death and threatening environment
Decreased cardiac output related to
Decreased cardiac output related to
impaired contraction of the heart

impaired contraction of the heart

Myocardial Infarction

Myocardial Infarction

Altered tissue perfusion (myocardial)
Altered tissue perfusion (myocardial)
related to coronary stenosis

related to coronary stenosis
Activity intolerance related to
Activity intolerance related to
insufficient oxygenation

insufficient oxygenation
Risk for injury (bleeding) related to
Risk for injury (bleeding) related to
dissolution of clots

dissolution of clots
Ineffective individual coping related to
Ineffective individual coping related to
threats to self esteem

threats to self esteem

Myocardial Infarction

Myocardial Infarction

Management:
Management:
CBR without BP
CBR without BP
Oxygen therapy
Oxygen therapy
Pain control
Pain control
Morphine or Meperidine
Morphine or Meperidine
Vasodilator (NTG)
Vasodilator (NTG)
Anxiolytic (Benzodiazepine)
Anxiolytic (Benzodiazepine)

Myocardial Infarction

Myocardial Infarction

Pharmacologic Therapy
Pharmacologic Therapy
Thrombolytic Agents
Thrombolytic Agents
TPA tissue plasminogen activator
TPA tissue plasminogen activator
Streptokinase (streptase)
Streptokinase (streptase)
Urokinase
Urokinase
Anticoagulant
Anticoagulant
Heparin
Heparin
Warfarin
Warfarin
Beta adrenergic blocking agents
Beta adrenergic blocking agents
Propranolol
Propranolol
Antidysrhythmic
Antidysrhythmic
Lidocaine (Xylocaine)
Lidocaine (Xylocaine)
Calcium Channel Blockers
Calcium Channel Blockers
Diltiazem
Diltiazem

Myocardial Infarction

Myocardial Infarction

Surgical revascularization:
Surgical revascularization:
PTCA Percutaneous Transluminal
PTCA Percutaneous Transluminal
Coronary Angioplasty

Coronary Angioplasty

CABG coronary artery bypass graft
CABG coronary artery bypass graft

Congestive Heart Failure

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->