Troponin : the reliable marker of an MI injury, the best one to tell if the patient has had an MI - It is detectable within a few hours of having an MI - The other ones take longer and won’t find out till the next day CPK- MB: MB: stands for heart muscle, will tell you if there’s any damage to the heart muscle LDH : an enzyme, tells the LOCATION of tissue damage, where in the heart 23
Myoglobin : Tells you how much protein is there to transport the oxygen C-Reactive Protein : Inflammation, produced in the liver but it increases when there’s inflammation Other MI meds - ASA : Aspirin (can be a pain reliever, antiplatelet, or syslioli pg 1066, Frequently used with Plavix to inhibit and enzyme that’s needed by the platelets to clot - Plavix : an antiplatelet works by decreasing platelet aggregation, works in the artery base clots. (need a prescription for) - Side Effects of Plavix o Flu like symptoms o Upper Respiratory infection symptoms - Antiplatelet : Inhibits from aggregating to form a plug (and that’s how aspirin and Plavix work) (So the platelets don’t stick together) - Anticoagulants : used to prevent clog formation or if you already have a clot to prevent it from becoming larger, work on Venous clots like DVTs, more combative than an antiplatelet therefore there are more serious side effects (heparin, lovenox, warfarin) o Monitor Heparin: pTT o Monitor Coumadin: pT (bleeding time) o Warfarin will inhibit the synthesis of Vitamin K - Aggregate : to unite; a mass or a cluster - Platelets : Form initial plug at rupture of blood vessel - Thrombolytic: medications that will deal with an immediate right now is have a heart attack or stroke. It actually dissolves the existing clot. o Tissue plasminogen (t-PA) o TNKase MI- Thrombolytic: - Tissue plasminogen- tPA - TNKase o When to administer? It must be given within 4 hours of the clot forming or starting to cause the problems, present a VERY high bleeding risk which is why there’s such strict criteria Other MI meds - Anti-dysrhythmic o Will discuss in Nsg4 , but it suppresses abnormal heart rhythms like A-fib - Already discussed o Beta Blocker, ACE inhibitor, stool softeners o Heparin (IV) and Lovenox (SubQ), do not rub after administration o Coumadin is given by mouth; the blood levels take a while to come up 24
o So, the patient may be on Heparin or Lovenox while they take the Coumadin, because they work differently so you’re not overdosing the patient. Once the pT levels come up to sufficient numbers then they’re will stop the heparin or the lovenox and go with the PO o INR: the normal range: 1.3-2.0 International normalized ratio o When on Warfarin they like to maintain the levels at 2.0-3.0 so we want the clotting time to take LONGER o Mechanical Valve or Recent embolism: Maintain 2.5-3.5 Monitor for Internal Bleeding: - Petechiae - Tarry stools MI: Complications Risk factors same as for CHD & Angina - Dysrhythmias - Decreased CO - Cardiogenic shock : When the heart as been damaged so much that is unable to supple enough blood has something that it is unable to supply blood to the organs - Pericarditis
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- Summer '13
- Diane Gomez
- Nursing, Nursing Care, HTN meds