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Heart attacksmartattack

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  • Upper body discomfort: including radiating pain to the left arm, jaw-line, shoulders, neck, stomach, backBack, shoulder, neck, jaw, teeth
  • Information about each test, what changes meanNormal lab values, values showing MIEKG – STEMI, T-wave inversion, tombstones, etc.
  • African Americans – higher risk for HTN .: Heart diseasePoverty – lack of availability of services, less likely to get help/have levels checked, etc.
  • Refer to board for this.
  • Transcript

    • 1. Heart Attacks
      Signs and Symptoms for Men & Women, How to Prevent Exacerbations of Myocardial Infarction & to Treat an MI
      Created by:
      Casey Burritt
      Jenna Lambeth
      Nicole Lazarczyk
    • 2. Learning Goals
      For healthcare professionals as well as the general population to understand the signs and symptoms of myocardial infarctions in men and women
      Use the steps of the nursing process to teach and help the staff to quickly identify and differentiate a myocardial infarction and other disease processes.
    • 3. Objectives
      Understanding the differentiating signs and symptoms of an Myocardial infarction (MI) between men & women
      Diagnostic tools for diagnosing an MI quickly and differentiating between other diseases & SMART attack tool
      Treatment protocols of a heart attack
      Prevention of exacerbated MI and teaching the need to acquire healthcare assistance
    • 4. Significance to Critical Care
      Non-healthcare professionals should know the signs and symptoms of a (MI) so that they know when to get help
      Healthcare providers should be able to accurately differentiate between an MI and other diseases
      Healthcare providers should be able to diagnoses and treat a heart attack
      Providers should also be able to teach about the prevention of heart disease that may cause a heart attack.
      The heart affects the ability of every body system to function correctly and adequately
    • 5. Signs and Symptoms of Heart Attacks
      Shortness of breath
      Substernal chest pain
      Upper body discomfort
      Diaphoresis
      Lightheadedness
      Nausea
      Chest pain
      Anxiety
      Dizziness
      Tachycardia
      Nausea/Vomitting
      Upper body discomfort
      Edema
      Dyspnea
      Fatigue
      Indigestion
      Numbness
      Men
      Women
      (McDonald, Goncalves, Almaria, Krajewski, Cervera, Kaeser, Lillvik, Sajkowicz, Moose, 2006) ; (Allegro Medical, 2010)
    • 6. Most Common Signs
      Chest pain
      Left arm pain
      Diaphoresis
      Dizziness
      Shortness of Breath
      Slow and mild pain at onset
      (Allegro Medical, 2010)
    • 7. Heart Attack, SMART Attack
      Substernal chest pain
      Crushing feelings, unable to catch breath
      Meals
      When last mean was eaten, whether pain comes within 1-2 hours of meals
      Worsens when laying flat
      Type of meal – spicy, acidic, high salt contents
      Angina
      Pain relieved with rest from activity, nitroglycerine
      Radiating
      To other locations such as arms, neck, shoulder, jaw, back, stomach
      Time
      Frequency of pain, duration
    • 8. Nursing Diagnoses
      Decreased Cardiac Output
      Impaired Tissue Perfusion
      Anxiety
      Ineffective Health Maintenance
      Acute Pain
      Activity Intolerance
      Disturbed Sleep Pattern
      Powerlessness
      Deficient Knowledge
      Ineffective Coping
      Risk for Altered Organ Functions
      Lough, Stacy, Urden, 2010
    • 9. Diagnostic Tools
      Lab values
      CPK-MB (normal: 0%)
      Troponin T (normal: less than 0.2ng/mL
      Troponin I (normal: less than 0.03ng/mL
      Cardiac Catheterization
      EKG changes
      PQRST
      Pagana & Pagana, 2006
    • 10. Treatment Protocols
      Troponin, CHEM-stat levels when walking in door
      Second Troponin at 6 hrs
      “STEMI-alert” Cardiac cath lab within 30 minutes (Sentara Protocol)
      Available open-heart operating room if necessary
      Stress test within 24hrs with a normal troponin level
      MONA
      Education
      Lough, Stacy, Urden, 2010
    • 11. Patient Education – Risk Factors
      Gender
      Age
      Family History
      Personal Baselines for cholesterol, blood pressure
      Race
      SES
      Smoking
      Diabetes
      Lack of Exercise
      Dietary Changes
      Birth Control Pills
      Menopausal Hormone Replacement
      Uncontrolled HTN
      Stress
      SES
      Non-Modifiable Risks
      Modifiable Risks
      MedicineNet, 2010
    • 12. Non-Modifiable Risk Factors
      Non-modifiable risk factors are things that cannot be changed no matter the circumstances
      Based on family and personal histories can allow a patient to remain healthy at higher than normal levels
      Regular healthcare appointments should be maintained so as to understand the risks that these factors may propose
      Those with excessively high non-modifiable risk factors should control their modifiable risk factors even better to prevent heart disease complications such as MIs
      MedicineNet, 2010
    • 13. Patient Education – Life Factors
      Your 1-year mortality risk increases for every 30 minutes it takes you to get to the hospital
      In the year prior to your MI you are more likely to suffer from depression, have sleep disturbances, and experience stressful life events than healthy people, especially in women
      Low education levels in patients and their partners predicted longer delay and total pre-hospital delay for men, but this does not affect women
      Reducing pre-hospital delay can be accomplished by increasing knowledge of the MI process
      Lovlien, Shei & Torstein, 2008
    • 14. Patient Education – Women with CAD
      Women with CAD delay seeking medical attention because their pattern of symptoms of an MI is different
      The symptoms they experience are very gradual and easily attributable to other causes such as a rough workout, stress, or extra physical work
      Their attributions to other causes and their personal perception of their health determines if and when they seek medical help and attention
      Albarran, Clarke & Crawford, 2006
    • 15. Nursing Process
      Assessment
      Diagnosis
      Outcomes/Goals
      Planning
      Implementation
      Evaluation
    • 16. Evaluation of Learning Objectives
    • 17. References
      Albarran, J., Clarke, B., & Crawford, J. (2007). 'It was not chest pain really, I can't explain it!' An exploratory study on the nature of symptoms experienced by women during their myocardial infarction. Journal of Clinical Nursing, 16(7), 1292-1301. Retrieved from CINAHL Plus with Full Text database.
      AllegroMedical. (2010). Heart attack & stroke warning signs: Men vs women. Retrieved October 14, 2010, from  http://www.allegromedical.com/blog/heart-attack-stroke-warning-signs- men-vs-women-510.html.
      Ignatvicus, D., Workman, M. (2010). Medical-Surgical Nursing:  Patient Centered Collaborative Care. Missouri: Saunders. 
      Løvlien, M., Schei, B., & Hole, T. (2008). Myocardial infarction: psychosocial aspects, gender differences and impact on pre-hospital delay. Journal of Advanced Nursing, 63(2), 148-154. Retrieved from CINAHL Plus with Full Text database.
      Lough, M., Stacy, K., Urden, L. (2010). Critical Care Nursing: Diagnosis and Management. Missouri: Mosby.
      McDonald, D., Goncalves, P., Almario, V., Krajewski, A., Cervera, P., Kaeser, D., et al. (2006). Assisting women to learn myocardial infarction symptoms. Public Health Nursing, 23(3), 216-223. Retrieved from CINAHL Plus with Full Text database.
      MedicineNet. (2010). Heart attacks: Women are different than men. Retrieved October 14, 2010, from http://www.medicinenet.com/script/main/art.asp?articlekey=10918.
      Pagana, K., Pagana, T. (2006). Mosbys’s Manual of Diagnostic and Laboratory Tests. Missouri: Mosby.

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