Your SlideShare is downloading. ×
0
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Cardio4
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Cardio4

504

Published on

Published in: Health & Medicine, Sports
1 Comment
0 Likes
Statistics
Notes
  • thanks
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

No Downloads
Views
Total Views
504
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
25
Comments
1
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. MYOCARDIAL INFARCTION
  • 2. PATHOPHYSIOLOGY
  • 3.  
  • 4.  
  • 5.  
  • 6. RISK FACTORS
  • 7. <ul><li>MALE </li></ul><ul><ul><li>40 years of age </li></ul></ul><ul><ul><li>with arterial HPN </li></ul></ul><ul><li>FEMALE </li></ul><ul><ul><li>taking oral contraceptives </li></ul></ul><ul><ul><li>smoking </li></ul></ul>
  • 8. CLINICAL MANIFESTATION
  • 9. <ul><li>CHEST PAIN </li></ul><ul><ul><li>occurs suddenly </li></ul></ul><ul><ul><li>continuous unabated </li></ul></ul><ul><ul><li>lower sternal region </li></ul></ul><ul><ul><li>upper abdomen </li></ul></ul><ul><ul><li> steadily in severity </li></ul></ul><ul><ul><li>until it becomes unbearable </li></ul></ul><ul><ul><li>heavy, “ viselike ” pain </li></ul></ul>
  • 10. <ul><ul><li>radiate to shoulders </li></ul></ul><ul><ul><li>down the arms (Left) </li></ul></ul><ul><ul><li>jaw and neck </li></ul></ul><ul><ul><li>begins spontaneously </li></ul></ul><ul><ul><li>persists for hours or days </li></ul></ul>C:WINDOWShinhem.scr
  • 11. <ul><ul><li>relieve neither by rest nor by nitroglycerin </li></ul></ul><ul><ul><li>accompanied by SOB, </li></ul></ul><ul><ul><li>pallor, diaphoresis, dizziness, lightheadedness, N/V </li></ul></ul>C:WINDOWShinhem.scr
  • 12. DIAGNOSTIC EVAULATIONS
  • 13. <ul><li>1. PATIENT HISTORY </li></ul><ul><ul><li>history of present illness </li></ul></ul><ul><ul><ul><li>diagnosis of MI </li></ul></ul></ul><ul><ul><ul><li>subjective </li></ul></ul></ul><ul><ul><li>history of present illness and family health history </li></ul></ul><ul><ul><ul><li>risk factors </li></ul></ul></ul>
  • 14. <ul><li>2. ECG </li></ul><ul><ul><li>electrophysiology of heart </li></ul></ul><ul><ul><li>monitor evolution and resolution of MI </li></ul></ul><ul><ul><li>determine location and relative size of infarction </li></ul></ul>
  • 15. NORMAL ECG ECG in MI
  • 16. <ul><li>3. ECHOCARDIOGRAM </li></ul><ul><ul><li>evaluate cardiac fnx (ventricular) </li></ul></ul><ul><ul><li>ejection fraction </li></ul></ul>
  • 17. <ul><li>4. SERUM ENZYMES AND ISOENZYMES </li></ul><ul><ul><li>CREATINE KINASE MB </li></ul></ul><ul><ul><ul><li> when there has been damage </li></ul></ul></ul><ul><ul><ul><li>cardiac-specific enzyme </li></ul></ul></ul><ul><ul><li>LACTIC DEHYDROGENASE </li></ul></ul><ul><ul><ul><li>LDH 1 and LDH 2  </li></ul></ul></ul>
  • 18. ASSESSMENT
  • 19. <ul><li>1. LEVEL OF CONSCIOUSNESS </li></ul><ul><ul><ul><li>Orientation </li></ul></ul></ul><ul><ul><ul><ul><ul><li>Time </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Place </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Person </li></ul></ul></ul></ul></ul><ul><ul><ul><li>Slurred speech </li></ul></ul></ul><ul><ul><ul><li>Deepening of snoring sounds </li></ul></ul></ul>
  • 20. <ul><li>2. CHEST PAIN </li></ul><ul><ul><li>pain rating intensity </li></ul></ul><ul><li>3. HEART RATE </li></ul><ul><ul><li>rate </li></ul></ul><ul><ul><li>unexplained  or  </li></ul></ul>
  • 21. <ul><li>4. HEART SOUNDS </li></ul><ul><ul><li>S1 apex; systole (lub) </li></ul></ul><ul><ul><li>S2 base; diastole (dub) </li></ul></ul>
  • 22. <ul><ul><li>ABNORMAL HEART SOUNDS </li></ul></ul><ul><ul><li>S3 ventricular gallop </li></ul></ul><ul><ul><li>S1- S2- S3 (ken-tucck-y) </li></ul></ul><ul><ul><li>S4 atrial or presystolic gallop </li></ul></ul><ul><ul><li>S4- S1- S2 (ten-nes-see) </li></ul></ul><ul><ul><li>heart murmur </li></ul></ul><ul><ul><li>friction rub </li></ul></ul>
  • 23. <ul><li>5. BLOOD PRESSURE </li></ul><ul><ul><li>vasodilator </li></ul></ul><ul><ul><li> BP </li></ul></ul><ul><li>6. PERIPHERAL PULSES </li></ul><ul><ul><li>blood flow to extremities </li></ul></ul><ul><li>7. IV SITES </li></ul><ul><ul><li>patency </li></ul></ul><ul><ul><li>signs of inflammation </li></ul></ul>
  • 24. <ul><ul><li>8. SKIN COLOR AND TEMPERATURE </li></ul></ul><ul><ul><ul><li>pink, warm skin </li></ul></ul></ul><ul><ul><ul><li>blue to purple nail beds, oral mucosa, ear lobes </li></ul></ul></ul><ul><ul><ul><li>cool, moist skin </li></ul></ul></ul>
  • 25. <ul><ul><li>9. LUNGS </li></ul></ul><ul><ul><li> or  rate of respiration </li></ul></ul><ul><ul><li>labored breathing </li></ul></ul><ul><ul><li>shortness of breath </li></ul></ul><ul><ul><li>dry, hacking cough </li></ul></ul><ul><ul><li>wheezes, crackles </li></ul></ul>
  • 26. <ul><li>10. GI FUNCTION </li></ul><ul><ul><li>N/V </li></ul></ul><ul><ul><li>abdomen </li></ul></ul><ul><ul><ul><li>Tenderness </li></ul></ul></ul><ul><ul><ul><li>Bowel sounds </li></ul></ul></ul><ul><ul><li>occluded Mesentric Artery </li></ul></ul><ul><li>11. FLUID VOLUME STATUS </li></ul><ul><ul><li>U/O </li></ul></ul><ul><ul><li>Edema </li></ul></ul>
  • 27. POSSIBLE NURSING DIAGNOSES
  • 28. <ul><li>Chest Pain </li></ul><ul><li>Decreased cardiac output </li></ul><ul><li>Ineffective cardiopulmonary tissue perfusion </li></ul><ul><li>Potential impaired gas exchange </li></ul><ul><li>Potential altered peripheral tissue perfusion </li></ul><ul><li>Risk for activity intolerance </li></ul><ul><li>Anxiety </li></ul><ul><li>Deficient knowledge </li></ul>
  • 29. PLANNING
  • 30. <ul><li>Relief of pain or ischemic signs and symptoms </li></ul><ul><li>Prevention of further myocardial damage </li></ul><ul><li>Absence of respiratory dysfunction </li></ul><ul><li>Maintenance or attainment of adequate tissue perfusion by increasing heart’s workload </li></ul>
  • 31. <ul><li>Reduce anxiety </li></ul><ul><li>Adherence to self-care program </li></ul><ul><li>Absence or early recognition of complications </li></ul>
  • 32. INTERVENTIONS
  • 33. <ul><li>Relieve chest pain </li></ul><ul><li>VASODILATORS </li></ul><ul><ul><li>IV Nitroglycerine </li></ul></ul><ul><li>ANTI-COAGULANTS </li></ul><ul><ul><li>Heparin </li></ul></ul><ul><li>THROMBOLYTICS </li></ul><ul><ul><li>Streptokinase </li></ul></ul><ul><ul><li>Tissue Type Plasminogen Activator </li></ul></ul><ul><ul><li>Anistreplase </li></ul></ul><ul><li>OXYGEN THERAPY </li></ul><ul><li>ANALGESIC </li></ul><ul><ul><li>Morphine Sulfate </li></ul></ul>
  • 34. <ul><li>Improve respiratory function </li></ul><ul><li>DBE </li></ul><ul><li>POSITIONING </li></ul><ul><li>Promote adequate tissue perfusion </li></ul><ul><li>OXYGEN THERAPY </li></ul>
  • 35. <ul><li>Reduce anxiety </li></ul><ul><li>TRUSTING and CARING RELATIONSHIP </li></ul><ul><li>Patient education and home care considerations </li></ul>
  • 36. EVALUATION
  • 37. <ul><li>After nursing interventions, </li></ul><ul><li>goal was met. </li></ul><ul><li>The client was able to: </li></ul><ul><ul><li>verbalize relief of pain </li></ul></ul><ul><ul><li>appear comfortable </li></ul></ul><ul><ul><li>demonstrate no signs of respiratory distress </li></ul></ul>
  • 38. <ul><ul><li>maintain adequate cardiac output as evidenced by: </li></ul></ul><ul><ul><ul><ul><li>strong peripheral pulses </li></ul></ul></ul></ul><ul><ul><ul><ul><li>normal blood pressure </li></ul></ul></ul></ul><ul><ul><ul><ul><li>clear breath sounds </li></ul></ul></ul></ul><ul><ul><ul><ul><li>adequate urine output </li></ul></ul></ul></ul><ul><ul><li>verbalize reduce fear </li></ul></ul><ul><ul><li>tolerate progressive activity </li></ul></ul><ul><ul><li>verbalize realistic expectations for progressive activity </li></ul></ul><ul><ul><li>verbalize understanding of condition and adhere to self-care program </li></ul></ul>

×