Critical Care
Management :
Applications in
Nursing
(CCRN)2026
A+
, lOMoAR cPSD| 65262174
S1, S3, S4- Heard at the apex
S2: Heard at the base
S3: Heart failure
S4: HTN, MI, ventricular hypertrophy, & aortic stenosis
Systolic-diastolic= Pulse Pressure
Normal 40-60 mmhg
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, lOMoAR cPSD| 65262174
Insufficiency (regurgitation) occurs when the valve is closed.
-Acute or chronic
Stenosis occurs when the valve is open.
-NOT Acute
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Unstable Angina: Chest pain at rest, may be relieved with NTG, Negative Troponin,
ST depression or T Wave inversion.
NSTEMI: Positive troponin, ST depression, unrelenting chest pain.
STEMI: Positive troponin, ST elevation, unrelenting chest pain ----------------
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Acute Chest Pain
• STAT EKG, read within 10 minutes,
• 325mg chewable aspirin ASAP
• anticoagulant therapy
• antiplatelet therapy
• beta blocker administration.
• Use metoprolol, NOT propranolol.
• Treat chest pain with morphine or nitroglycerin.
• If symptoms have been present <12 hours, prepare for PCI. Door to balloon
in 90 minutes. Door to fibrinolytic therapy in 30 minutes
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, lOMoAR cPSD| 65262174
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