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27 - Management of Patients With Coronary Vascular DisordersAce Your Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Ed., Hinkle & Cheever Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Ed., Hinkle & Cheever | Registered Nurse (RN) School Study Aid
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Cardiac Enzyme Evaluation: Myoglobin
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 1 - 4 Hours
- Peak: 12 Hours
- Return to Normal: 24 Hours
- Considerations
- Elevation After 24 Hours: Reinfarction
2 mins
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Cholesterol Lab Values
- LDL (Low Density Cholesterol)
- < 100 mg/dL
- HDL (High Density Cholesterol)
- > 40 mg/dL Males
- > 50 mg/dL Females
- Total Cholesterol
- < 200 mg/dL
1 min
Troponin Lab Values
- Troponin T (cTnT)
- < 0.1 ng/mL Normal
- Troponin I (cTnI)
- < 0.5 ng/mL Normal
- > 2.3 ng/mL Myocardial Injury
2 mins
Therapeutic Diets
- Common Therapeutic Diets
- High Fiber
- Low Residue (Fiber)
- Low Sodium
- Low Cholesterol
- Diabetic
- Renal
- Dysphagia
- Nursing Considerations
- Diet Education
2 mins
Heart Failure Interventions
- Diagnostic Tests
- Echocardiogram
- Invasive Hemodynamic Monitoring
- Improve Gas Exchange
- High Fowler's Position
- Oxygen
- Advanced Airway
- Drugs and Devices
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
2 mins
Myocardial Infarction Assessment
- Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Considerations
- Monitor for Arrhythmias
2 mins
Myocardial Infarction Diagnosis
- Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Considerations
- Early ECG
- Cardiac Stress Test
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Stable Angina
- Assessment
- Chest Pain with Exertion
- Relieved within 15 Minutes
- ST Depression
- Interventions
- Nitroglycerin
- Up to 3 Doses q 5 Minutes
- Rest
- Antiplatelet Medication
- CABG
- Angioplasty
2 mins
Unstable Angina
- Assessment
- Chest Pain with Rest or Exertion
- Limits ADLs
- > 15 Minutes
- Less Likely Relieved by Nitroglycerin
- ST Depression
- Fatigue
- Considerations
- Acute Coronary Syndrome (ACS) Treatment
- Emergency Treatment
2 mins
Alteplase
- Mechanism
- Tissue Plasminogen Activator
- Indications
- Thrombosis
- Side Effects
- Bleeding
- Contraindications
- Intracranial Hemorrhage
- Internal Hemorrhaging
- Considerations
- Minimize Bleeding
- Monitor for Shock
- Antidote
- Aminocaproic Acid
2 mins
Aspirin (Acetylsalicylic Acid)
- Mechanism
- Inhibits Platelet Aggregation
- NSAID
- Indications
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Side Effects
- Pancytopenia
- GI Ulcers
- Bleeding
- Considerations
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Atorvastatin (Lipitor)
- Characteristics
- -statin Suffix
- Mechanism
- HMG-CoA Reductase Inhibitors
- Indications
- High Cholesterol
- Side Effects
- Hepatotoxicity
- Rash
- Rhabdomyolysis
- Myopathy
- Considerations
- Monitor Liver Enzymes
- Administer at Bedtime
- Avoid Grapefruit
2 mins
Beta Blockers
- "-olol" suffix
- Mechanism
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Indications
- Hypertension
- Heart Failure
- Angina Pectoris
- Contraindications
- Asthma and Heart Block Patients
- Nursing Considerations
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
2 mins
Bile Acid Resins
- Indications
- Hyperlipidemia
- Mechanism of Action
- Bile Acid Reabsorption Prevented
- Decrease LDL
- Drugs
- Colestipol (Colestid)
- Cholestyramine (Questran)
- Colesevelam (Welchol)
- Side Effects
- GI Distress
- Cholesterol Gallstones
- Decreased Absorption of Fat-soluble Vitamins
2 mins
Nitroglycerin
- Mechanism of Action
- Decreases Preload
- Indications
- Angina
- Up to 3 doses q 5 mins
- Side Effects
- Headache
- Hypotension
- Contraindications
- Viagra (Sildenafil)
- Nursing Considerations
- Assess Blood Pressure
- Protect From Light
- Use Glass Bottle and Special Tubing
- Gloves for Applying Topically
2 mins
Vitamin B3 - Niacin (Nicotinic Acid)
- Mechanism
- Decreases Triglycerides
- Decreases LDL
- Increases HDL
- Indications
- Dyslipidemia
- Pellagra
- Diarrhea
- Dermatitis
- Dementia
- Side Effects
- Flushing
- GI Distress
- Hepatotoxicity
2 mins
Coronary Arteries
- Aortic Root
- Right Coronary Artery (RCA)
- Right (Acute) Marginal Artery
- Posterior Descending Artery (PDA)
- Left Coronary Artery (LCA)
- Left Anterior Descending (LAD) Artery
- Circumflex Artery
- Left Marginal Artery
1 min
Statins
- Rhabdomyolysis
- Hepatotoxicity
- HMG-CoA reductase inhibitors
- Decrease LDL
- Decrease Triglycerides
- Increase HDL
2 mins
