- Do not give with grapefruit, check liver function prior to giving; these can
cause toxicity.
- Observe for signs of toxicity; muscle pain, and rhabdomyolysis.
- Nausea, flatulence, and constipation are adverse effects. This is the most
important class of lipid lowering medications, and most frequently
prescribed.
- Cholesterol is synthesized at night so instruct patient to take at night for
best efficacy.
MAP - ANSWER (SBP + 2 DBP) / 3
Diagnosis of diabetes - ANSWER A1C >6.5%
,Most common problem of CAD - ANSWER atherosclerosis
non-STEMI - ANSWER occluding thrombus causes tissue necrosis, elevated
cardiac enzymes - may see ECG changes but not ST elevation
STEMI - ANSWER Complete thrombus occlusion causing infarction of the
tissue, will see ST elevation or LBBB
Treatment for stable angina - ANSWER A Antiplatelet, antianginal,
anticoagulant, ace arb
B Beta blocker BP control
C Cigarette smoking, cholesterol mgmt., CCB, cardiac rehab
D diet, diabetes mgmt., depression screening, vaso dilator (nitroglycerin)
,E education, exercise
F flu vaccination
MI s/s - ANSWER - pain: tightness, crushing, substernal, unrelieved by nitro
- dyspnea
- nausea
- vomiting
- diaphoresis
- denial
- increased HR
- decreased BP
ST elevation - ANSWER >1mm in two contiguous limb leads or >2mm in two
contiguous chest leads
MI lab test - ANSWER - Troponin I & T
- Creatine kinase -MB
- Myoglobin
- C-reactive protein
MI nursing intervention - ANSWER - ABCs
- Aspirin
- O2 if low
- monitor ECG
, - repeat 12-lead ECG & blood work
- pain relief with nitrate first then opioid if needed
- auscultate heart & lungs
MONA - ANSWER - morphine
- oxygen (only if low)
- nitroglycerin
- aspirin
complications of MI - ANSWER - dysrhythmia
- HF
- cardiogenic shock
- papillary muscle dysfunction
- ventricular aneurysm
- acute pericarditis
- Dressler syndrome
Dressler syndrome - ANSWER pericarditis and fever 1-8 weeks post MI
sudden cardiac death - ANSWER - abrupt disruption in cardiac function
resulting in loss of CO and cerebral blood flow
- death usually within 1 hour of onset of acute symptoms
MI treatment - ANSWER - angioplasty (PTCA)
- thrombolytic agents
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