NR341- Week 3 notes: Nursing Care: Complex Perfusion
Alterations, Nursing Care: Acute Coronary Syndrome,
Nursing Care: Cardiac Dysrhythmias Questions With
Complete Solutions
Women & Myocardial Infarction
Risk ↑ after 55 (post-menopause).
Atypical symptoms common: unusual fatigue, neck/jaw/back
pain, arm pain, indigestion, shortness of breath, weakness,
dizziness/syncope, cold sweat, nausea/vomiting, sleep problems.
Post-Myocardial Infarction Complications
Dysrhythmias (ventricular tachycardia/ventricular fibrillation,
heart blocks).
Heart failure: left (dyspnea→pulmonary congestion), right
(jugular venous distention, hepatosplenomegaly, edema).
Cardiogenic shock: high mortality, reduced by rapid STEMI
treatment.
Aneurysm/rupture; septal defect; pericarditis.
Percutaneous Coronary Intervention & Nursing
Post-care checks: pulses, site for bleeding, new chest pain →
electrocardiogram, vital signs, bedrest/leg straight.
Thrombolytics
-STEMI only, give within 30 minutes.
, -Absolute contraindications: active bleeding, prior intracranial
hemorrhage, recent intracranial/spinal surgery, vascular
malformations, ischemic stroke (≤3 months), severe
uncontrolled hypertension, recent head trauma, suspected aortic
dissection.
Medications for Acute Coronary Syndrome
Antiplatelets: aspirin, clopidogrel, ticagrelor.
Nitroglycerin: vasodilator; side effects: hypotension, headache.
Morphine: for pain unrelieved by nitro; monitor for respiratory
depression/hypotension.
Beta-blockers: reduce oxygen demand; start within 24 hours,
continue indefinitely.
Angiotensin-converting enzyme inhibitors/angiotensin
receptor blockers: prevent remodeling.
Statins: lifelong for most clients.
Nutrition & Psychosocial
Diet: low sodium/saturated fat/cholesterol; increase fiber/fluids;
stool softener to avoid vagal bradycardia.
Anxiety/adjustment: family presence, clear explanations,
promote rest, support systems.
Nursing Management
Acute: serial electrocardiogram, cardiac monitoring, vital signs,
oxygen, nitroglycerin/opioids, cardiac biomarkers, bedrest,
elevated head of bed, close monitoring.
Alterations, Nursing Care: Acute Coronary Syndrome,
Nursing Care: Cardiac Dysrhythmias Questions With
Complete Solutions
Women & Myocardial Infarction
Risk ↑ after 55 (post-menopause).
Atypical symptoms common: unusual fatigue, neck/jaw/back
pain, arm pain, indigestion, shortness of breath, weakness,
dizziness/syncope, cold sweat, nausea/vomiting, sleep problems.
Post-Myocardial Infarction Complications
Dysrhythmias (ventricular tachycardia/ventricular fibrillation,
heart blocks).
Heart failure: left (dyspnea→pulmonary congestion), right
(jugular venous distention, hepatosplenomegaly, edema).
Cardiogenic shock: high mortality, reduced by rapid STEMI
treatment.
Aneurysm/rupture; septal defect; pericarditis.
Percutaneous Coronary Intervention & Nursing
Post-care checks: pulses, site for bleeding, new chest pain →
electrocardiogram, vital signs, bedrest/leg straight.
Thrombolytics
-STEMI only, give within 30 minutes.
, -Absolute contraindications: active bleeding, prior intracranial
hemorrhage, recent intracranial/spinal surgery, vascular
malformations, ischemic stroke (≤3 months), severe
uncontrolled hypertension, recent head trauma, suspected aortic
dissection.
Medications for Acute Coronary Syndrome
Antiplatelets: aspirin, clopidogrel, ticagrelor.
Nitroglycerin: vasodilator; side effects: hypotension, headache.
Morphine: for pain unrelieved by nitro; monitor for respiratory
depression/hypotension.
Beta-blockers: reduce oxygen demand; start within 24 hours,
continue indefinitely.
Angiotensin-converting enzyme inhibitors/angiotensin
receptor blockers: prevent remodeling.
Statins: lifelong for most clients.
Nutrition & Psychosocial
Diet: low sodium/saturated fat/cholesterol; increase fiber/fluids;
stool softener to avoid vagal bradycardia.
Anxiety/adjustment: family presence, clear explanations,
promote rest, support systems.
Nursing Management
Acute: serial electrocardiogram, cardiac monitoring, vital signs,
oxygen, nitroglycerin/opioids, cardiac biomarkers, bedrest,
elevated head of bed, close monitoring.
