Treatment of Myocardial Infarction CPR with defibrillation MONA (morphine, oxygen, nitrates, aspirin) ◦ Chewing aspirin is part of emergency protocol Sublingual nitroglycerin Thrombolytic therapy – contraindications? ◦ Heparin ◦ Altepase (t-PA) ◦ Streptokinase ◦ Tenecteplase (TNKase) National standards listed in box 20-2
Acute Care of Myocardial Infarction Relieve pain Medications as ordered watching for side effects Monitor for s/s of complication ◦ Dysrhythmia, heart failure, pulmonary edema, pericarditis, cardiogenic shock, or cardiac arrest ◦ See table 20-3 pg 460 Maintain patent IV at all times
Recovery of Myocardial Infarction Decrease anxiety Assessment every 4-8 hrs, vitals every 2-4 hours Daily weight Promote rest and increase activity as tolerated/ordered ADLs
Cardiac Surgery Percutaneous transluminal coronary angioplasty (PTCA) ◦ Balloon used to open artery, stent used to keep open ◦ Drug-eluting stent suppresses cell growth so body does not occlude the vessel with new cells Coronary artery bypass graft surgery (CABG) ◦ If multiple vessels are occluded ◦ Bypasses the blockage using the saphenous vein ◦ MIDCAB: minimally invasive direct coronary bypass that does NOT require heart to be stopped Laser angioplasty ◦ Breaks up the clot
Figure 20-6, A
Guidelines for recovery Patient teaching (p. 463) Recognize signs Exercise Control risk factors Reduce stress Observe for complications ◦ Chest pain, pulse rate, dyspnea, fatigue Take medications as prescribed
Postoperative Care Specialized cardiac monitoring Chest tubes for drainage and proper reexpansion of the lungs Autologous blood transfusion Temporary epicardial pacemaker Physical and emotional disability Rehabilitation
You've reached the end of your free preview.
Want to read all 23 pages?
- Fall '19
- Atherosclerosis, acute myocardial infarction, infarction, Dyspnea