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Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020/
35 - Critical Care of Patients With Acute Coronary SyndromesAce Your Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid
35 - Critical Care of Patients With Acute Coronary Syndromes
35 Picmonics to Learn | 1 hr 1 min
Stable Angina
- Assessment
- Chest Pain with Exertion
- Relieved within 15 Minutes
- ST Depression
- Interventions
- Nitroglycerin
- Up to 3 Doses q 5 Minutes
- Rest
- Antiplatelet Medication
- CABG
- Angioplasty
2 mins
Unstable Angina
- Assessment
- Chest Pain with Rest or Exertion
- Limits ADLs
- > 15 Minutes
- Less Likely Relieved by Nitroglycerin
- ST Depression
- Fatigue
- Considerations
- Acute Coronary Syndrome (ACS) Treatment
- Emergency Treatment
2 mins
Metabolic Syndrome
- Assessment
- Dyslipidemia
- Central Obesity
- Insulin Resistance
- Hypertension
- Increased C-Reactive Protein (CRP)
- Increased Fibrinogen
- Considerations
- Increased Risk Cardiovascular Disease
1 min
Mexican American Culture
- May Avoid Eye Contact with Authoritative Figures
- Family Involved in Decisions
- Emotional Bereavement
- No Organ Donation
- Curandero (Curandera)
- Hot-Cold Theory of Illness
- Abdominal Binder after Pregnancy
2 mins
Hypertension Assessment
- Mechanism
- Essential Hypertension
- Secondary Hypertension
- Assessment
- Headache
- Vision Changes
- Nosebleed (Epistaxis)
- Chest Pain
- Syncope (Fainting)
- Diagnosis
- Average 2 Sets, 2 Minutes Apart
- After 2 or More Visits (within 1-4 weeks)
- Nursing Considerations
- Take BP Both Arms
- Common in African Americans
2 mins
12 Lead Contiguous Leads - Anterior Wall MI
- Leads Elevated
- Lead V3
- Lead V4
- Artery Affected
- Left Anterior Descending (LAD)
56 secs
12 Lead Contiguous Leads - Inferior Wall MI
- Leads Elevated
- Lead II
- Lead III
- Lead aVF
- Artery Affected
- Right Coronary Artery (RCA)
56 secs
12 Lead Contiguous Leads - Lateral Wall MI
- Leads Elevated
- Lead I
- Lead aVL
- Lead V5
- Lead V6
- Artery Affected
- Circumflex
1 min
12 Lead Contiguous Leads - Septal Wall MI
- Elevated Leads
- Lead V1
- Lead V2
- Artery Affected
- Left Anterior Descending (LAD)
48 secs
Myocardial Infarction Assessment
- Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Considerations
- Monitor for Arrhythmias
2 mins
Myocardial Infarction Diagnosis
- Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Considerations
- Early ECG
- Cardiac Stress Test
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Aspirin (Acetylsalicylic Acid)
- Mechanism
- Inhibits Platelet Aggregation
- NSAID
- Indications
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Side Effects
- Pancytopenia
- GI Ulcers
- Bleeding
- Considerations
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
2 mins
Nitroglycerin
- Mechanism of Action
- Decreases Preload
- Indications
- Angina
- Up to 3 doses q 5 mins
- Side Effects
- Headache
- Hypotension
- Contraindications
- Viagra (Sildenafil)
- Nursing Considerations
- Assess Blood Pressure
- Protect From Light
- Use Glass Bottle and Special Tubing
- Gloves for Applying Topically
2 mins
Acetaminophen
- Indications
- Fever
- Pain
- Mechanism of Action
- Reversibly Inhibits COX
- Acts Primarily in CNS
- Side Effect
- Hepatic Necrosis
- N-acetylcysteine Antidote
51 secs
Morphine
- Mechanism
- Opioid Receptor Agonist
- Indications
- Pain
- Myocardial Infarction
- Side Effects
- Nausea and Vomiting
- CNS Depression
- Biliary Colic
- Constipation
- Increased Intracranial Pressure (ICP)
- Pupillary Constriction
- Hypotension
2 mins
Abciximab and Tirofiban (GP IIb/IIIa Inhibitors)
- Mechanism
- IIb/IIIa Receptor Inhibitors
- Inhibits Platelet Aggregation
- Indications
- Thrombotic Event Prevention
- Acute Coronary Syndrome (ACS)
- Percutaneous Coronary Intervention (PCI)
- Side Effects
- Bleeding
- Considerations
- Expensive
- Combination Drug Therapy
2 mins
Clopidogrel (Plavix)
- Mechanism
- ADP Receptor Antagonist
- Prevent Platelet Aggregation
- Indications
- Acute Coronary Syndrome (ACS)
- Prevention of Thrombotic Events
- Side Effects
- Bleeding
- Thrombotic Thrombocytopenic Purpura (TTP)
- Pancytopenia
- Abdominal Pain
- Considerations
- Withhold Before Surgery
2 mins
Beta Blockers
- "-olol" suffix
- Mechanism
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Indications
- Hypertension
- Heart Failure
- Angina Pectoris
- Contraindications
- Asthma and Heart Block Patients
- Nursing Considerations
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
2 mins
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
- Mechanism of Action
- Block Renin Angiotensin-Aldosterone System (RAAS)
- Indications
- Hypertension
- Heart Failure
- Side Effects
- Dry Non-productive Cough
- Hypotension
- Dizziness
- Possible Hyperkalemia
- Angioedema
- Nursing Considerations
- Slowly Change Position
- Do Not Stop Abruptly
2 mins
Angiotensin II Receptor Blockers (ARBs)
- Ends in "-sartan"
- Mechanism of Action
- Blocks Angiotensin II Receptor
- Indications
- Hypertension
- Side Effects
- Angioedema
- Contraindications
- Renal Artery Stenosis
- Pregnancy
1 min
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Statins
- Rhabdomyolysis
- Hepatotoxicity
- HMG-CoA reductase inhibitors
- Decrease LDL
- Decrease Triglycerides
- Increase HDL
2 mins
Atorvastatin (Lipitor)
- Characteristics
- -statin Suffix
- Mechanism
- HMG-CoA Reductase Inhibitors
- Indications
- High Cholesterol
- Side Effects
- Hepatotoxicity
- Rash
- Rhabdomyolysis
- Myopathy
- Considerations
- Monitor Liver Enzymes
- Administer at Bedtime
- Avoid Grapefruit
2 mins
Alteplase
- Mechanism
- Tissue Plasminogen Activator
- Indications
- Thrombosis
- Side Effects
- Bleeding
- Contraindications
- Intracranial Hemorrhage
- Internal Hemorrhaging
- Considerations
- Minimize Bleeding
- Monitor for Shock
- Antidote
- Aminocaproic Acid
2 mins
Heparin (Unfractionated)
- Mechanism of Action
- Suppresses Coagulation
- Indications
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Side Effects
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Considerations
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Antidote
- Protamine Sulfate
2 mins
Enoxaparin (Lovenox)
- Mechanism of Action
- Inhibits Clotting Factors
- Factor Xa
- Indications
- Clot Formation Prevention
- Side Effects
- Heparin Induced Thrombocytopenia (HIT)
- Bleeding
- Considerations
- Medication Education
- Subcutaneous Injection
- 2 Inches from Umbilicus or Incisions
- Antidote
- Protamine Sulfate
2 mins
Blood Pressure Classification (JNC 7)
- Classifications
- Normal
- Systolic (<120)
- Diastolic (< 80)
- Prehypertension
- Systolic +20 (120-139)
- Diastolic +10 (80-89)
- Stage 1 Hypertension
- Systolic +20 (140-159)
- Diastolic +10 (90-99)
- Stage 2 Hypertension
- Systolic + > 20 (160)
- Diastolic + > 10 (100)
- Hypertensive Crisis
- Systolic > 180
- Diastolic > 110
4 mins
Nitroprusside
- Mechanism of Action
- Direct Release of NO
- Increase cGMP
- Short Half-Life
- Indications
- Malignant Hypertension
- Side Effect
- Cyanide Toxicity
1 min
Sodium Nitroprusside (Nitropress)
- Mechanism
- Venous and Arterial Dilation
- Indications
- Hypertensive Crisis
- Side Effects
- Cyanide Toxicity
- Thiocyanate Toxicity
- Hypotension
- Considerations
- Short Term Administration
- Light Sensitive, Use Container
- Continuous BP Monitoring
2 mins
Dobutamine
- Mechanism
- Beta-1 Agonist
- Inotropic
- Indications
- Heart Failure
- Side Effects
- Tachycardia
- Arrhythmias
- Considerations
- Closely Monitor Patients
- Other Meds May Increase Potency
1 min
Beta-1 Agonists
- Dobutamine
- Heart Failure
- Cardiac Stress Test
- Isoproterenol
- Bradyarrhythmias
- Torsades de Pointes
58 secs
Coronary Artery Bypass Grafting (CABG)
- Indications
- ST-Segment Elevation Myocardial Infarction (STEMI)
- Cardiovascular Disease (CAD)
- Uncontrolled Angina
- Considerations
- Internal Mammary Artery
- Saphenous (Leg) Vein
- Transient Limb Edema
- Closely Monitor Patients
- Venous Thromboembolism (VTE) Prophylaxis
- Incentive Spirometer
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
NSAIDs
- Indications
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Mechanism of Action
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Side Effects
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
1 min
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