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Critical Care ROK 2[latest cc 2020]

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Cardiac Alterations  Acute MI o Signs and symptoms  S/S in women- extreme fatigue, diaphoresis, abdominal discomfort, arm and shoulder pain, nausea/vomiting, indigestion, SOB, bradycardia, d ... izziness, hypotension  Normal s/s- midsternal chest pain, Severe, crushing, and squeezing pressure may radiate, unrelieved with nitrates, pale and diaphoretic, dyspnea and tachypneic, syncope, nausea and vomiting, dysrhythmias o Diagnostic tests: based on s/s, analysis of 12 lead ECG, and cardiac enzymes  12-lead: ST elevation followed by Q wave formation (Q-wave myocardial infarction or STEMI) – This is the more severe type of AMI, requires immediate intervention send to Cath Lab. A STEMI occurs b/c of plaque rupture leading to complete occlusion of artery. 1 st thing you do  ST depression (non–Q-wave myocardial infarction or NSTEMI). NSTEMI results from a partially occluded coronary vessel> heparin, nitro> then will go to cath lab  Elevated cardiac enzymes- serial enzymes every 6 hours  CPK & CPK-MB  Serum troponin I: (0.05) most specific for cardiac muscle, will rise w/in after injury  Myoglobin  PTT ( ), INR 2-3, CBC, electrolytes  Stress test: exercise the heart while monitoring VS and ECG  Chest x-ray: can show fluid and a mass [Show More]

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