Treatment & Prevention: - Anti-platelet medications, such as aspirin - ACE Inhibitors, such as lisinopril - Beta-blockers, such as metoprolol - Anti-lipemics,

such as atorvastatin - EtOH in moderation - Follow instructions on OTC meds - Lifestyle changes, such as eating healthier foods - Maintain a healthy weight - Smoking cessation - Manage chronic medical conditions - Exercise regularly - Reducing and managing stress

TNL, 55 yo Kosraean male

Etiology: Presence of > 6 risk factors (hx of DM, HTN, smoking, obesity, high cholesterol, heart disease, genetic predisposition.)

Thrombus formation due to ruptured or cracked atherosclerotic plaque

Risk Factors: - Diabetes Mellitus - Diet (high in fat/carbohydrates) - Hyperlipoproteinemia - Hypertension - Obesity - Sedentary lifestyle - Smoking - Stress - Age - Gender (male) - Genetic predisposition/family hx

Thrombus fully occludes the vessels and involves the full thickness of the ventricular wall for a prolonged time NDx: Activity Intolerance r/t impaired cardiovascular status secondary to STEMI, VTACH aeb arrhythmias and EKG changes

Epidemiology: - Worldwide more than 3 million people have STEMIs and 4 million have NSTEMIs a year. - The World Health Organization (WHO) estimates there will be about 20 million CVD deaths in 2015, accounting for 30 percent of all deaths worldwide. NDx: Decreased cardiac output r/t altered cardiovascular status secondary to STEMI AND VTACH aeb variations in blood pressure/EKG readings

Imbalance in myocardial oxygen supply and demand

Ischemia Nursing Interventions: - Remove barriers that prevent patient from achieving goals that have been established - Encourage participation in self-care, as tolerated, and provide positive reinforcement for patients activities - Provide as many opportunities as possible for patient to make decisions about self-care i.e. choosing an injection site, positioning, etc - Provide emotional support and activity encouragement to patients level of tolerance - Teach caregivers to assist patient with self-care activities in a way that maximizes patients potential

Cellular injury

Cell death

MDx: STEMI

Nursing Interventions: - Monitor for irregularities in cardiac rate, dyspnea, fatigue, and chest pain every 4 hours - Monitor and record LOC, heart rate, BP every 4 hours - Auscultate for adventitious heart and breath sounds every 4 hours. Report abnormal sounds as they develop - Administer medications and oxygen, as prescribed - Teach patient how to perform stress-reduction techniques (such as deep breathing and meditation)