1 / 5

Acute Myocardial Infarction Management Guidelines

Learn about the treatment and interventions for Acute Myocardial Infarction (AMI), including thrombolytic therapy, cardiac enzyme monitoring, coronary interventions, and post-procedure nursing care.

avongara
Download Presentation

Acute Myocardial Infarction Management Guidelines

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TREATMENT OF ACUTE MYOCARDIAL INFARCTION NUR 351/352 PROFESSOR DIANE E. WHITE RN MS CCRN

  2. Acute Myocardial Infarction (AMI) is ischemia with death to the myocardium caused by lack of blood supply • Can be classified as Q-wave or non-Q wave • Q-wave results from total occlusion of coronary artery represented by in elevated ST segment and cardiac enzymes • Non-Q wave results from partially occluded & associated with ST depression and increased cardiac enzymes • Dx: 12-lead ECG, Cardiac Enzymes • 12-lead vs 5-lead placement • CK, CK-MB, Troponin levels

  3. INTERVENTIONS • Pain Relief • Morphine – increases collateral circulation • NTG – vasodilates 5-200 mcg.min titrated • Oxygen • 4-6 L/min nasal cannula • Decrease Platelet Aggregation • Aspirin po • Repro ( gtt for 12 hours after bolus IV per kg) • Aggrestat (weight based continuous gtt)

  4. Thrombolytic Therapy • Criteria of Usage: patient symptomatic for less than 6 hour, 20 minutes of CP not relieved by NTG, & Q-wave AMI • Agents – • -- Streptokinase: increase risk of reactions in patient’s with recent strep infections, less expensive but less reperfusion • -- TPA: tissue plasminogen activator; caution with bleeding; bolus and gtt changes every hour for 3 then gtt runs at same rate for 3 hours • -- TNK: tenecteplase a newer agent; single dose, 30-50mg over 5 seconds based on patient’s weight

  5. ** Heparin is still used in conjunction with other medications and sometimes with thrombolytics. Usually seen in Non- Q wave AMI • Cardiology Interventions • PTCA – percutaneous transluminal coronary angioplasty; compresses intracoronary plaque • Coronary Rotational Atherectomy – compresses & shaves the plaque off the vessel wall & removes it with a rotablator • Intracoronary Shunt – tubes placed at site of stenosis • Nursing Care After Procedures

More Related