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NUR213 Exam 1
5 Rights of Delegation
- Right Task
- Right Circumstance
- Right Person
- Right Direction/Communication
- Right Supervision/Evaluation
1 min
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
Coronary Artery Bypass Grafting (CABG)
- Indications
- ST-Segment Elevation Myocardial Infarction (STEMI)
- Cardiovascular Disease (CAD)
- Uncontrolled Angina
- Considerations
- Internal Mammary Artery
- Saphenous (Leg) Vein
- Transient Limb Edema
- Closely Monitor Patients
- Venous Thromboembolism (VTE) Prophylaxis
- Incentive Spirometer
2 mins
Cardiac Catheterization
- Considerations
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- After Procedure
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
2 mins
Evolution of Myocardial Infarction and Complications
- Hours to Days
- Arrhythmia
- Before 7 Days
- Fibrinous Pericarditis
- Papillary Muscle Rupture
- Interventricular Septum Rupture
- Before 14 Days
- Ventricular Pseudoaneurysm
- Ventricular Free Wall Rupture
- After 14 Days
- True Ventricular Aneurysm
- Dressler Syndrome
- Other
- Left Ventricular Failure
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
Parts of an ECG
- PQRST
- P Wave
- Atrial Depolarization
- QRS Complex
- Ventricular Depolarization
- T Wave
- Ventricular Repolarization
2 mins
ECG Interpretation
- Rate
- Rhythm
- P Waves
- Upright, Rounded, Before Every QRS
- PR Interval (< 0.20 seconds)
- Normal QRS (< 0.12 seconds)
2 mins
ECG: Sinus Bradycardia
- Rate
- < 60 bpm
- Rhythm
- Regular
- P Wave
- Present, Upright, Every QRS
- PR Interval
- < 0.20 seconds
- QRS Interval
- < 0.12 seconds
- Treatment
- Atropine
1 min
ECG: Sinus Tachycardia
- Rate
- > 100 bpm
- Rhythm
- Regular
- P Wave
- Present, Upright, Every QRS
- PR Interval
- < 0.20 seconds
- QRS Interval
- < 0.12 seconds
- Treatment
- Treat Underlying Cause
2 mins
ECG: Atrial Flutter
- Rate
- Variable
- Rhythm
- Regular or Irregular
- P Wave
- Saw Tooth, Multiple Before Every QRS
- PR Interval
- Non-measurable
- QRS Interval
- < 0.12 seconds
2 mins
ECG: Atrial Fibrillation
- Rate
- Variable Rate
- Rhythm
- Irregular Rhythm
- P Wave
- No P Wave
- PR Interval
- No PR Interval
- QRS Interval
- QRS < 0.12 Seconds
1 min
Torsades de Pointes
- Characteristics
- Polymorphic Ventricular Tachycardia
- Prolonged QT Interval
- QRS Twist Around Isoelectric Line
- Causes
- Congenital
- Antibiotics
- Antiarrhythmics
- Antipsychotics
- Antidepressants
- Electrolyte Deficiencies
- Complications
- Ventricular Fibrillation
- Treatment
- Stable: Magnesium Sulfate
- Unstable: Defibrillation
3 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
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: 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
