11063844
Descrição
Mapa Mental por Jessica Caswell, atualizado more than 1 year ago
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Criado por Jessica Caswell
aproximadamente 7 anos atrás
|
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NSTEMI
- Pathophysiology
- Occurs as a result
of sustained
ischemia, which
leads to irreversible
myocardial cell
death (text book)
- Partial or complete
coronary artery
blockage (White &
Chew, 2008)
- 80-90% of MI's
occur secondary
to thrombus
formation
(Textbook)
- This thrombotic process decreases circulation to
to coronary arteries leading to necrosis (White &
Chew, 2008)
- The heart stops
contracting in
these necrotic
areas (Textbook)
- Cardiac cells can last up to 20
minutes before cellular death
takes place (Textbook)
- The most inner layer of the heart,
subendocardium, becomes ischemic first (Textbook)
- If this ischemia continues the entire thickness of the heart will
become necrossed in roughly 5 to 6 hours (Textbook)
- The most inner layer of the heart,
subendocardium, becomes ischemic first (Textbook)
- The heart stops
contracting in
these necrotic
areas (Textbook)
- This thrombotic process decreases circulation to
to coronary arteries leading to necrosis (White &
Chew, 2008)
- Atherosclerosis is a build of plaque in the artery wall (Heart & Stroke, ?)
- Artery can narrow and become blocked
- Can lead to blood clots, which can block the blood from getting to the heart
- Can lead to blood clots, which can block the blood from getting to the heart
- Artery can narrow and become blocked
- Occurs as a result
of sustained
ischemia, which
leads to irreversible
myocardial cell
death (text book)
- Diagnostic Studies
- Electrocardiogram
- 12 Lead ECG
- Will reveal ST segement depression
- Primary tool in detecting Myocardial Infarctions
- Reveals the time sequence of ischemia, infarction and the resolution of the infarction
- No pathalogical Q waves are developed (Text)
- 12 Lead ECG
- Serum Cardiac
Markers
- Creatine Kinase
(CK-MB)
- In an MI, plasma CK-MB levels
rise about 4-6 after the onset
of chest pain and typically
peaks 12-24 hours after
(Coven, 2016)
- Levels typically return
to baseline after
24-48 hours (Coven,
2016)
- Levels typically return
to baseline after
24-48 hours (Coven,
2016)
- In an MI, plasma CK-MB levels
rise about 4-6 after the onset
of chest pain and typically
peaks 12-24 hours after
(Coven, 2016)
- Troponin
- Regulatory protiens that
are found in skeletal and
cardiac muscle (Coven,
2016)
- A positive result is noted 4-8 hours after the
onset of symptoms, and remains elevated for
7-10 days after (Coven, 2016)
- Cardiac Specific
troponin is a
myocardial
muscle protein
released into
circulation
after an
myocardial
injury (Text)
- Two different sub types: cardiac specific troponin I (cTnI) & cardiac specific troponin T (cTnT) (Text)
- Two different sub types: cardiac specific troponin I (cTnI) & cardiac specific troponin T (cTnT) (Text)
- Highly specific
indicators of MI and
have a greater
sensitivity to detect
(text)
- Regulatory protiens that
are found in skeletal and
cardiac muscle (Coven,
2016)
- Creatine Kinase
(CK-MB)
- Coronary Angiography
- Is an X-ray to determine if there are any
blockages in the coronary arteries (NLH, 2016)
- A small catheter is inserted through an artery
- A small catheter is inserted through an artery
- Determines most therapeutic treatment (text)
- Percutaneous Intervention (PCI) may be performed at this time (Text)
- intervention used to treat CAD
- A catheter with a balloon on the end is insterted and the inflated into the artery that is narrowed (Text)
- Elective procedure once the patient is stabilized (Text)
- Elective procedure once the patient is stabilized (Text)
- intervention used to treat CAD
- Is an X-ray to determine if there are any
blockages in the coronary arteries (NLH, 2016)
- Electrocardiogram
- Nursing Assessments
- Subjective
Data
- Important health history
- Current health history
- Family history of heart disease
(text)
- a sedentary lifestyle
- Use of tobacco
- Family history of heart disease
(text)
- Past health history/ history of
- CAD
- Hypertension
- Aortic Stenosis
- Diabetes
- MI
- Angina
- Heart
failure
- Lung disease
- Hyperlipidemia
- CAD
- Medications
- The use
of:
- Aspirin
- Nitrates
- Beta Blockers and Calcium Channel Blockers
- ACE Inhibitors
- Herbal supplements or vitamins
- Anti-Hypertensive and Cholesterol Lowering
medications
- Aspirin
- The use
of:
- Current health history
- Symptoms
- Chest pressure or
pain
- May radiate to jaw,
neck, shoulders, arms
or back
- May radiate to jaw,
neck, shoulders, arms
or back
- Heartburn, N/V, indigestion
- Dyspnea
- Dizziness and weakness
- Anxiety, heart palpatations and tiredness
- Chest pressure or
pain
- Important health history
- Objective
Data
- General
- Anxiety
- Restlessness
- Fear
- Anxiety
- Integumentary
System
- Cool, clammy and pale
(text)
- Cool, clammy and pale
(text)
- Cardiac
System
- Bradycardia or Tachycardia
- Pulses will alternate from weak to
strong
- S3 & S4
- High or Low Blood Pressure
- Bradycardia or Tachycardia
- Potential Findings
- Non-elevated or
elevated cardiac serum
markers
- Increased WBCs and serum
lipids
- Cardiac enlargement
- Positive stress test
results
- ECG abnormalities
- Pulmonary congestion or
calcification seen on chest
radiograph
- Positive findings on
the coronary
angiogram
- Non-elevated or
elevated cardiac serum
markers
- General
- Subjective
Data
Anexos de mídia
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