PCI care
What is eat?
What is to stop the activity, rest, and try again later. ?
When managing a patient with active ACS, the nurse initiates supplemental oxygen only if the O2 sat falls below this percentage.
What is 90%?
Three non modifiable factors that cannot be altered.
What are: increasing age (over 65), gender (males develop earlier) and family history. ?
The nurse teaches the patient to do this with their chest when coughing or deep breathing.
What is splint their chest?
To monitor the patient for arterial occlusion after the procedure, an important nursing priority is to assess this.
What are peripheral pulses ?
Dorsalis pedis pulse.
To prevent a dangerous vagal response or sudden syncope caused by bearing down, the nurse ensures the post MI patient is prescribed this medication.
What is a stool softener?
ACS are most frequently caused by this sudden, microscopic vascular event within a diseased coronary artery.
What is atherosclerotic plaque rupture?
When preparing a patient to undergo a serum lipid profile, in order to make it accurate, the nurse instructs the patient to maintain this strict dietary restriction.
What is fasting 12 hours before the blood draw?
The percentage an artery must be occluded in order to be eligible for the procedure.
What is 70%.? 50% if the left main coronary artery.
The six P's used to monitor for arterial insufficiency.
Pain - sudden or worsening discomfort in affected limb
Pallor - paleness/loss of normal skin color in extremity
Pulse - diminished/weakened or absent pulse
Paresthesia - numbness, tingling sensation
Poikilothermia (temperature) - coldness or coolness to the skin
Paralysis - inability to move extremity
A post MI client taking nitrates should never take sildenafil because the combination can trigger this life threatening cardiovascular emergency.
What is profound, potentially fatal hypertension.?
When assessing a female patient, the nurse will look for these clinical presentations, rather than classic crushing chest pain.
What are: extreme fatigue, sleep disturbances, and epigastric pain/ indigestion.
This or lower is the desirable ratio to predict low heart attack risk.
What is 4.5?
Beck's triad includes these three classic signs.
Bonus points for the FIRST SIGN of cardiac tamponade.
What are: hypotension with narrowed pulse pressure, jugular vein distension and muffled/distant heart sounds?
3 D's of Beck's triad for cardiac tamponade
Decreased blood pressure
Distended neck veins
First sign is usually decreased chest tube output.
Distant/muffled heart sounds
Three priority nursing interventions if a post femoral catheterization patient is having a vasovagal reaction (bradycardia, hypotension and nausea).
What are: elevating the lower extremities, infusing a bolus of IV fluids and administering IV atropine. ?
To monitor the extend of cardiac muscle necrosis/injury, the nurse expects blood specimens for cardiac biomarkers to be drawn at this specific interval for the first 24 hours.
What is every 6 to 8 hours?
This protein marker can detect injury within hours and remains elevated for up to 2 weeks.
What is troponin?
The differences between stable and unstable angina.
What are:
Stable: chest pain during activity, heavy meals or stress, but stops at rest and is made better with nitro.
Unstable: Chest pain even at rest and is not relieved with nitroglycerin.
This medication, when given at least 24 hours before CABG, reduces the incidence of post operative atrial fibrillation.
What are beta blockers ?
Name 3 differences between radial and femoral access.
What are:
Femoral: Patient on bedrest for 2 to 6 hours, affected leg must be kept straight, HOB no greater than 30 degrees to prevent stress on bleeding site.
Radial access: lower risk of bleeding, patient can sit upright in chair, ambulation encouraged after sedation has worn off.
The nurse emphasizes this as the number one cause for MI reoccurrence.
What is non adherence to medication?
Differences between STEMI and NSTEMI.
What is:
STEMI: Complete coronary artery occlusion - Needs PCI
Signs and symptoms, EKG changes and cardiac markers
NSTEMI: Partial - meds - possible PCI
Signs and symptoms and cardiac markers. ?
Unstable angina is a medical emergency because it is caused by this acute arterial event.
What is atherosclerotic plaque rupture followed by thrombus formation causing coronary artery occlusion ?
These three medication types are held or adjusted before the procedure.
What are: anticoagulant agents, antihypertensives, and diabetic medications. ?