Pain Management Nitroglycerin Morphine sulfate Oxygen Position of comfort semi

Pain management nitroglycerin morphine sulfate oxygen

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Pain ManagementNitroglycerinMorphine sulfateOxygenPosition of comfort; semi-Fowler’s positionQuiet & calm environmentIneffective Tissue Perfusion (Cardiopulmonary)Interventions:Drug therapy (aspirin, thrombolytic agents)Restoration of perfusion to injured area limits amount of extension, improves left ventricular functionComplete sustained reperfusion of coronary arteries in first few hours after MI has decreased mortalityThrombolytic TherapyFibrinolytics dissolve thrombi in coronary arteries, restore myocardial blood flowTissue plasminogen activatorReteplaseTenecteplaseOther Drug TherapiesGlycoprotein (GP) IIB/IIIa inhibitorsOnce-a-day beta blockersACE inhibitors or angiotensin receptor blockersCalcium channel blockersRanolazine (Ranexa)Reperfusion TherapyMyocardial tissue can become increasingly ischemic and necroticThrombolytic therapy using fibrinolytics dissolves thrombi in the coronary arteries and restores myocardial blood flowCardiogenic Shock Necrosis of more than 40% of left ventricleTachycardiaMedical ManagementPain relief and decreased myocardial oxygen requirements through preload and afterload
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HypotensionBlood pressure <90 mm Hg or 30 mm Hg lessthan patient’s baselineUrine output <30 mL/hrCold, clammy skinPoor peripheral pulsesAgitation, restlessness, confusionPulmonary congestionTachypneaContinuing chest discomfortreductionDrug therapyIntra-aortic balloon pumpImmediate reperfusionPercutaneous Transluminal Coronary AngioplastyClopidogrel before procedureIV heparin after procedureIV or intracoronary nitroglycerin or diltiazemPossible IV GP IIb/IIIa inhibitorsLong-term therapy, antiplatelet therapy, beta blocker, ACE inhibitor, or ARBOther ProceduresArthrectomyStentsRheolytic thrombectomyCoronary Artery Bypass Graft Surgery Preoperative carePostoperative careManage F&E balanceComplication:hypotension, hypothermia, hypertension, bleeding, cardiac tamponade, change LOCCommunity-Based CareHome care managementTeaching for self-managementHealth care resources
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