Lab Values
<100 normal
>500 is clinically significant; Elevated in CHF
BNP
Dissolves clots and restores perfusion in MI or stroke
Fibrinolytics (-ase)
Pain associated with physical activity lasts <5min
Angina Pectoris (Stable Angina)
Immediate treatment of an MI
Oxygen (first), morphine, nitro, asa
CABG Post-operative Care
Decreased CO, Hypothermia, Pain Control, Impaired Gas Exchange (Ventilator/ETT care), Infection, ICU psychosis
0-3% normal >5% =MI
CK-MB
Reduce myocardial oxygen consumption by blocking sympathetic stimulation
Hold for hypotension, HR <50; wean off
contraindicated pts. w/chronic lung disorders
Beta- Adrenergic Blockers
i.e. metroprolol
plaque build up causes narrowing of the artery
Atherosclerosis
4 Major areas of health promotion and prevention
controlling cholesterol, quit smoking, manage HTN, controlling DM
circulatory support device for cariogenic shock
Intra-Aortic Balloon Pump
May indicate an MI
Detected 2-4hrs;peak24-36hrs Duration 1-14 days
Troponin
Decrease the work load of the heart; Decrease BP
Hold for bradycardia, heart block; hypotension or heart failure
Calcium Channel Blockers
Amlodipine, nifedipine
crushing pain, dyspnea, syncope, N?V, extreme weakness, diaphoresis, denial is common, elvtd HR,
Myocardial Infarction (MI) S/S
MAP
measures the pressure necessary for adequate perfusion
Normal 70-100; 2 x diastolic + systolic / 3
Central Venous Pressure Monitoring
catheter placement, HOB <45degrees, monitor for hematoma
Normal levels 5-10 cm water
>10 hypervolemia <5 hypovolemia
20-39 seconds normal
Therapeutic 60-70 secs (2-3 time baseline)
aPTT
Reduces myocardial O2 consumption which decreases ischemia
Can cause HA, hypotension, and decrease BP
Nitrates
Nitroglycerin
narrowing of the artery
Arteriosclerosis
O2, IV, Meds, monitor, dietary restrictions, PCI, Surgery, Pacemaker
MI Treatment
Bridge for heart transplant
Ventricular Assist Devices
Cholesterol Levels
Total serum <200; Triglycerides <150
LDL <100; HDL >40-60
Clopidogrel
Plavix - Antiplatelet
CP that occur at rest; Severe pain
Not relieved by rest or Nitroglycerin
Acute Coronary Syndrome/Unstable Angina
MI
Assess cardiovascular response to increased workload by treadmill (PA) or medication
Exercise Stress Test
Invasive x-ray procedure used to evaluate cardiac filling pressures, CO and valvular functions; check pulses, NPO 8-12 hrs
Cardiac Catherization