myocardial infarction treatment Proctored Exam.

Initial/routine care mnemonic for MI - correct answer MONA (B) MONA (B) - correct answer morphine oxygen nitroglycerin Aspirin Beta blockers when is oxygen given for MI - correct answer when SpO2 90% nitroglycerin for MI - correct answer SL or IV, reduces preload and O2 demand, increases blood flow to ischemic region of heart, controls HTN caused by STEMI aspirin for MI - correct answer suppresses platelet aggregation, should be chewed beta blockers for MI - correct answer PO or IV, reduce cardiac pain, infarct size, and short term mortality (reduce oxygen demand) Morphine for MI - correct answer IV, relieves pain, improves hemodynamics by promoting venodilation and reducing preload reperfusion therapy - correct answer need to restore blood flow through the blocked coronary artery two types of reperfusion therapy for MI - correct answer 1. primary percutaneous coronary intervention (PCI) 2. Fibrinolytic (thrombolytic) therapy adjuncts to reperfusion therapy for MI - correct answer - anticoagulants - antiplatelets combined with low dose aspirin - ACE inhibitors - angiotensin II receptor blockers (ARBs) primary percutaneous coronary intervention (PCI) - correct answer usually balloon angioplasty coupled with placement of a drug-eluting stent to re-open an occluded coronary artery goal time for PCI - correct answer within 90 minutes of contact with patients which therapy is preferred for MI? - correct answer PCI fibrinolytic (thrombolytic) therapy - correct answer dissolve clots by converting plasminogen into plasmin, a proteolytic enzyme that digests the fibrin meshwork that holds clots together drugs available for fibrinolytic therapy - correct answer ateplase (tPA), reteplase, tenecteplase timing for fibrinolytic therapy - correct answer within 30 minutes of contact with patient, not given if pain present 12 hours absolute contraindications to fibrinolytic drugs - correct answer - prior intracranial hemorrhage - known structural cerebrovascular lesion - ischemic stroke in last 3 months - known intracranial neoplasm - active internal bleeding (other than period) - severe uncontrolled hypertension - suspected aortic dissection