MI, Angina, CAD III

Med Surg: Cardiac

Anticoagulants (clot prevention) Bleed Risk (Patient Education)

Antiplatelets (LESS potent)

ASA & Clopidogrel
Platelets LESS than 50k = RISKY (Normal: 150–400k) NO peptic ulcers (or active bleeds)
NOT INR or PTT NO Rugs/dim halls (well-lit halls)
Anticoagulants (MOST potent) NO razors, hard brushing, constipation
Warfarin = INR “warINR” NO NSAIDS like naproxen/ ibuprofen
Range: 2.5–3.5 (3 x MAX range) NO EGGO vitamins
Antidote: Vitamin K (green leafy veggies) *NOT K+ = potassium* E–E Echinacea, Vitamin A
Heparin (Enoxaparin) = aPTT “HaPTT” frog Partial Thromboplastin G–Gingko, Garlic, Ginseng
Range: 46–70 (3 x MAX range) O–Omega 3
Antidote: Protamine Sulfate

MYOCARDIAL INFARCTION
Treatment
(+) Positive Troponin = Heart Attack (MI)
PRIORITY: REMOVE THE CLOT!
“CATH LAB” OR SURGERY CLOT BUSTER “Thrombolytics, Fibrinolytics”
“PCI” -graphy, -plasty
t-PA: Alteplase, Streptokinase (Allergy risk)
Dissolves Clot ONLY (heparin does NOT)
BLEED RISK
8 hour duration
NO injections (IV, SQ, IM, ABG)
NOT via central lines (CVC)
ONLY “compressible site” (IV, PICC)
NOT FOR:
Active Bleeds:
Peptic Ulcers (but menstruation is safe)
History:
Arteriovenous malformations
BEFORE AFTER Intracranial “Cerebral” hemmorhage
NPO 6 - 12 hrs NO heavy lifting–lie flat Hypoglycemia (relative contraindication)
NO Baths–Shower ok (dont soak) Hypertension (over 180/110) TEST TIP
Infected Incision
“red, warm, drainage”

STRESS TEST
Non MI (non priority) • Spot the Narrowing

TREADMILL STRESS TEST CHEMICAL: NUCLEAR PHARMACOLOGICAL STRESS TEST

24–48 hours BEFORE
STOP test: NO Cigarettes, Caffeine (tea, soda, coffee) *NO DECAF
chest pain NO Meds: Nitro, Beta Blocker, Theophylline (stimulant)
ST elevation NPO (nothing oral) 4 hrs before/after

NormalNormal ST elevation
ST elevation