NUR 504 W3- Cardiac Rhythms, Pacemakers, Myocardial Infarction Questions and Correct Answers
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Course
NUR 504
Institution
NUR 504
What is a myocardial infarction? - medical emergency - myocardial tissue abruptly and severely deprived of oxygen - results in irreversible death of myocardial cells - require immediate revascularization of blocked coronary artery
What are the three zones of myocardial infarction? 1. zone of necro...
NUR 504 W3- Cardiac Rhythms,
Pacemakers, Myocardial Infarction
Questions and Correct Answers
What is a myocardial infarction? ✅- medical emergency
- myocardial tissue abruptly and severely deprived of oxygen
- results in irreversible death of myocardial cells
- require immediate revascularization of blocked coronary artery
What are the three zones of myocardial infarction? ✅1. zone of necrosis: completely
dead
2. zone of injury: cells are injured
3. zone of ischemia: not getting enough o2 but can restore
What causes a myocardial infarction? ✅- coronary vasospasm
- spontaneous dissection
- Atherosclerosis: sluggish blood flow due to narrowing of the coronary artery
How to diagnose myocardial infarction? ✅- EKG changes: inverted or peaked T waves
- cardiac biomarkers: troponin (released with myocardial necrosis 3-12 hrs after chest
pain, peak at 24-48 hrs, return to baseline at 5-14 days), creatinine kinase, CK-MB
(isoenzyme of creatinine kinase)
S/s of MI: ✅- fullness, indigestion, chocking
- n/v
- intense crushing pain chest neck and left arm
- anxiety, or impending doom
- lightheaded, syncope
, - SOB
- tachypnea
- JVD
- wheezing
- rapid or irregular pulse
Medical management of MI: ✅- require immediate revascularization of blocked
coronary artery (elevation of l. ventricular function, PCI w/in 90 min and no more than 12
hours after symptoms)
- therapeutic hypothermia
- coronary artery bypass graft
Medical management of MI: ✅- statins: to prevent it
- P2Y12 receptor inhibitors (clopidegril, ticagrelor): prevent further clotting
- aspirin
- supplemental o2
- nitroglycerin
- morphine
- fibrolytic therapy (tenecteplase, reteplase, alteplase*)
Nursing interventions for MI: ✅- ACLS algorithm
- if fibrolytic started: labs (ptt, antXa), monitor for bleed
- focused cardiac assessment
- hemodynamic monitoring
- labs: troponin
- alleviate anxiety
- comfortable environment
- structure routines and rest periods
- I&O
ACLS Algorithm ✅
What is pt teaching for someone with unstable angina on nitroglycerin? ✅headache is
a normal side effect
What is different about an NSTEMi vs a STEMI? ✅STEMI: classic heart attach, full
occlusion, elevated ST, and troponin
NSTEMI: intermediate form with partial occlusion, just elevated troponin and treated
with anticoags until catheterized
Medical management of an NSTEMI: ✅- heparin drip: prevent further clot formation
- beta-blockers
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