Exam 2: CAD DAY 2 Flashcards Preview

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Flashcards in Exam 2: CAD DAY 2 Deck (28)
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1
Q

Other Care for Acute Coronary Syndrome

A
  1. CABG
  2. Minimally Invasive Direct CAB
  3. Fibrinolytic Therapy
2
Q

CABG

A

New passage between aorta and past coronary arterial obstruction

3
Q

Commonly used grafts for CABG

A

Internal Mammary Artery

Saphenous Vein

4
Q

Very important point to remember after CABG

A

Antiplatelet Therapy

5
Q

When is fibrinolytic therapy used?

A

When facility does not have an interventional cardiac cath lab

6
Q

What is a fibrinolytic

A

Dissolves thrombus (clot buster)

7
Q

When should fibrinolytic be given?

A

W/in 6 hours of onset of symptoms

Ideally within the 1st hour

8
Q

Advantages of minimally invasive direct coronary artery bypass

A

Decreased cost and length of stay
Shorter Recovery
Not true open heart surgery

9
Q

Criteria for fibrinolytic therapy

A
  1. Chest pain typical of MI (< 12 hrs in duration)
  2. ECG finding consistent w/ acute STEMI
  3. No absolute contraindications
10
Q

Absolute Contraindications of fibrinolytic therapy

A

Hx: intracranial hemorrhage, intracranial tumor, ischemic stroke, severe uncontrolled HTN, active bleeding, aortic dissection, streptokinase therapy w/in 6 mo.

11
Q

What should the patient’s blood pressure be in order to use fibrinolytics?

A

> 180/110 mmHg

12
Q

Potential Nursing responsibilities w/ fibrinolytic therapy

A
  1. Baseline labs. 2. IV lines. 3. All invasive procedures before infusion started. 4. Monitor HR, V/S, O2 sat. Watch for repercussion dysrhythmias. 5. Monitor Heparin drip. 6. Watch for bleeding. 7. Monitor Cardiac Biomarkers
13
Q

Treatments based on Evidence based practice

A

Core Measures

14
Q

Core Measures for Acute MI

A
  1. Aspirin on arrival. 2. Aspirin prescribed @ discharge. 3. ACE or ARB @ discharge. 4. Smoking Cessation Advice. 5. B-Blocker @ discharge. 6. Fibrinolytic therapy w/in 30 min of arrival. 7. PCI w/in 90 min of arrival. 8. Inpatient mortality. 9. Statin prescribed @ discharge.
15
Q

Potential Nursing Dx for Acute MI:

A

Acute Pain
Decreased Cardiac output
Ineffective tissue perfusion
Anxiety; Activity intolerance

16
Q

Complications of MI

A
  1. Dysrhythmias. 2. Heart Failure. 3. Cardiogenic shock. 4. Papillary muscle dysfunction. 5. Pericarditis. 6. Dressler Syndrome
17
Q

Friction rub r/t inflammation in pericardial sac

A

Pericarditis

Dressler syndrome

18
Q

Pericarditis w/ effusion and fever 4-6 weeks after MI

A

Dressler Syndrome

19
Q

Nursing care after Acute MI

A

Provide Education: Cardiac rehab; proper NTG use; dietary teaching; maintain ideal body weight; exercise; emotional support; resumption of sexual activity

20
Q

Team of people who work together to improve patient quality of life; collaborative

A

Cardiac rehabilitation

21
Q

What should nurse teach about diet after MI

A

low fat; low sodium

22
Q

Why is it important for patient to exercise after MI

A

Decrease mortality rate and risk of heart failure

23
Q

Why should the nurse be concerned with emotional support for the patient after MI?

A

Increased risk of depression; scared and complete lifestyle change

24
Q

When can the patient resume sexual activity after MI?

A

7-10 days after

Avoid ED meds w/ nitrate use.

25
Q

What is the usual cause for sudden cardiac death

A

Acute ventricular dysrhythmias

26
Q

Risk factors for sudden cardiac death (SCD)

A
Ejection fraction (EF) < 30%
Ventricular dysrhythmias
27
Q

Treatment for survivors of SCD

A

ICD
LifeVest
Psychosocial Needs: time bomb; reluctant to resume normal activities; loneliness/withdrawal

28
Q

How should nurse respond after SCD?

A

Presence/touch - be available
Allow expression of feelings from family
Allow for moments of silence
Be honest & direct; Allow family to have closure