The prolong complications of coronary artery disease such as angina pectoris, myocardial infarction, cardiac heart failure, its management and surgical mgt.
Normal Heart & Angina
Angere= Inflammation
Pectus= Chest
Angina Pectoris commonly known as Angina, characterised by chest pain due to imbalance between O2 supply & O2 demand in cardiac muscle or tissue due to the defect or blockage in the coronary artery.
Also known as CAD
A) Classical Angina/Stable Angina
Atheroma Deposition
Defect in coronary artery
Excessive exercise(O2 D )
Stress & tension
Predictable
Coronary Artery blocks
Blood supply to heart decreases
Heart unable to consume sufficient O2
O2 demand increases rather than supply
Antihyperlipidemic should be given.
to fat deposition on coronary
artery wall.
Antiplatelet & Thrombolytic are given.
to thrombin/platelet aggregation.
Calcium channel blockers (CCBs) are given.
to vasoconstriction.
The prolong complications of coronary artery disease such as angina pectoris, myocardial infarction, cardiac heart failure, its management and surgical mgt.
Normal Heart & Angina
Angere= Inflammation
Pectus= Chest
Angina Pectoris commonly known as Angina, characterised by chest pain due to imbalance between O2 supply & O2 demand in cardiac muscle or tissue due to the defect or blockage in the coronary artery.
Also known as CAD
A) Classical Angina/Stable Angina
Atheroma Deposition
Defect in coronary artery
Excessive exercise(O2 D )
Stress & tension
Predictable
Coronary Artery blocks
Blood supply to heart decreases
Heart unable to consume sufficient O2
O2 demand increases rather than supply
Antihyperlipidemic should be given.
to fat deposition on coronary
artery wall.
Antiplatelet & Thrombolytic are given.
to thrombin/platelet aggregation.
Calcium channel blockers (CCBs) are given.
to vasoconstriction.
General cardiovascular system
• Diagnostic tests p. 621
o ECG
o Stress ECG
o CXR
o Echo
o Cardiac cath
o Angiography
o Doppler studies
o Pulse oximetry
• Haematological studies p. 623
o Serum electrolytes
o Blood gases
o Serum enzymes
o Serum lipids
• Classification of cardiac disorders p. 629
• Risk factors p. 629
Congenital heart defects p. 630
• Description of congenital defects
o ASD
o VSD
o PDA
o Tetralogy of Fallot
• Clinical manifestations of congenital defects
• Management
Disorders associated with the conducting system p 633
• Specific dysrhythmias of the atria p. 634
o PAC
o Atrial flutter
o Atrial Fibrillation
• Ventricular dysrhythmias p 637
o Ventricular tachycardia
o Ventricular fibrillation
o Ventricular asystole
• Management
Congestive cardiac failure p. 644, PCCM 81
• Aetiology
• Pathophysiology
• Classification of CCF
o Systolic HF
o Right sided
o Left sided
• Clinical manifestations
o Respiratory
o GIT
o Oedema
o Renal
o Neurological
o Other
o Physical examination
o Summary table 33.6
• Diagnostic test results
• Management
o See N/care plan p 624
o PCCM p 84
Bed rest
Stress relief
Diet
Exercise
Smoking / alcohol
Refer
Medication
• Nursing management
Cardiac trauma p 647, p 216, table 33.7
• Stabbed heart PCCM 272
Management of coronary artery disease
• Risk factors p 651
• Pathophysiology p 651
• Nursing assessment p 652
o Subjective/ Objective
• Diagnostic test results p 653 (not SGOT)
Angina p 653 PCCM p 91 (T&E Periods)
• Stable
• Unstable
• Clinical features pain PCCM 91
• Management P 653 PCCM 91
Myocardial infarct p 653 PCCM p 92 (T&E Periods)
• Clinical manifestations p 654 PCCM 92
• Clinical features pain PCCM 92
• Management
o Medical
o PTCA /CABG
o Nursing
Diagnoses
Outcomes
Interventions
• Complications
o Cardiogenic shock
o Cardiac failure
o Deep vein thrombosis
o Pulmonary embolism
• Essential health information
General cardiovascular system
• Diagnostic tests p. 621
o ECG
o Stress ECG
o CXR
o Echo
o Cardiac cath
o Angiography
o Doppler studies
o Pulse oximetry
• Haematological studies p. 623
o Serum electrolytes
o Blood gases
o Serum enzymes
o Serum lipids
• Classification of cardiac disorders p. 629
• Risk factors p. 629
Congenital heart defects p. 630
• Description of congenital defects
o ASD
o VSD
o PDA
o Tetralogy of Fallot
• Clinical manifestations of congenital defects
• Management
Disorders associated with the conducting system p 633
• Specific dysrhythmias of the atria p. 634
o PAC
o Atrial flutter
o Atrial Fibrillation
• Ventricular dysrhythmias p 637
o Ventricular tachycardia
o Ventricular fibrillation
o Ventricular asystole
• Management
Congestive cardiac failure p. 644, PCCM 81
• Aetiology
• Pathophysiology
• Classification of CCF
o Systolic HF
o Right sided
o Left sided
• Clinical manifestations
o Respiratory
o GIT
o Oedema
o Renal
o Neurological
o Other
o Physical examination
o Summary table 33.6
• Diagnostic test results
• Management
o See N/care plan p 624
o PCCM p 84
Bed rest
Stress relief
Diet
Exercise
Smoking / alcohol
Refer
Medication
• Nursing management
Cardiac trauma p 647, p 216, table 33.7
• Stabbed heart PCCM 272
Management of coronary artery disease
• Risk factors p 651
• Pathophysiology p 651
• Nursing assessment p 652
o Subjective/ Objective
• Diagnostic test results p 653 (not SGOT)
Angina p 653 PCCM p 91 (T&E Periods)
• Stable
• Unstable
• Clinical features pain PCCM 91
• Management P 653 PCCM 91
Myocardial infarct p 653 PCCM p 92 (T&E Periods)
• Clinical manifestations p 654 PCCM 92
• Clinical features pain PCCM 92
• Management
o Medical
o PTCA /CABG
o Nursing
Diagnoses
Outcomes
Interventions
• Complications
o Cardiogenic shock
o Cardiac failure
o Deep vein thrombosis
o Pulmonary embolism
• Essential health information
Antonio Pérez Esclarín - Jesús, maestro y pedagogoMatias Rodriguez
Es interesante analizar las técnicas que utilizó Jesús para su pedagogía, tales como las parábolas, las preguntas, las metáforas, las ironías, los símbolos y otras.
Trataremos de dar respuesta a estas inquietudes y establecer claramente la pedagogía de Jesús y las técnicas utilizadas para dar a conocer al pueblo todo lo referente al reino de Dios.
A brief description for 2nd year MBBS students about IHD- MI,Unstable Angina by Dr Sabu Augustine. content from other presentations (ppts)and text books
Angina pectoris is a clinical syndrome usually characterized by episodes of pain or pressure in the anterior chest . The cause is usually insufficient coronary blood flow which results in a decreased oxygen supply to meet an increased myocardial demand for oxygen in response to physical exertion or emotional stress.
تم تحميل هذا الملف من
منتديات تمريض مستشفى غزة الاوروبي
http://egh-nsg.forumpalestine.com/
لتحميل اجمل واروع المحاضرات فقط قم بزيارتنا وسوف تكون من الاوائل
مع تحيات المدير العام
علاء شعت
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
4. Cont.
conditions result from CAD
1. Angina Pectoris
2. Myocardial Infarction
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5. Angina Pectoris
Definition:
Angina: Choking or suffocation.
Pectoris:Chest.
Angina pectoris, is the medical term
used to describe acute chest pain
It occurs when heart muscle doesn’t
get so much blood as it need.
This isn usually occurs when heart
arteries ius narrowed or bvlocked
also called Iscghemia.
6. Cont.
Types of Angina
Stable angina:
People with stable angina have
episodes of chest discomfort
that are usually
predictable. That occur on
exertion or under mental or
emotional stress.
Normally the chest discomfort
is relieved with rest,
nitroglycerin (GTN) or both.
It has a stable pattern of
onset, duration and intensity
of symptoms.
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7. Cont.
Unstable angina:
It is triggered by an un
predictable degree of
exertion or emotion.
(progressive), more
severe than stable.
Characterized by
increasing frequency &
severity. Provoked by less
than usual effort,
occurring at rest &
interferes with pt
lifestyle.
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8. Cont.
Variant Angina
(Prinzmetal’s or resting
angina) :
occur spontaneously with no
relationship to activity.
Occurs at rest due to spasm.
Pt discomfort that occurs
rest usually of longer
duration. Appears to by
cyclic & often occurs at
about the same time each
day (usually at night).
Thought to be caused by
coronary artery spasm
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9. Mechanism Of Angina
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14. Myocardium Infarction
Myo means muscle, “Cardiac”
heart, infarction means “death
of tissues due to lack of blood
supply”.
It is also called heart attack.
It occurs when coronary
arteries become blocked and
the part of myocardial
muscles become dead due to
prolonged lack of oxygen
supply to the muscle cells.
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15. PATHOPHYSIOLOGY
Coronary artery cannot supply enough blood to the
heart in response to the demand due to CAD
Within 10 seconds myocardial cells experience ischemia
Ischemic cells cannot get enough oxygen or glucose
Ischemic myocardial cells may have decreased
electrical & muscular function
Cells convert to anaerobic metabolism.
Cells produce lactic acid as waste
Pain develops from lactic acid accumulation
Pt feels anginal symptoms until receiving demand
increase 02 requirements of myocardial cells03/10/17
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16. ECG changes in Angina & MI
Zone of Ischemia: T wave inversion
Zone of Injury: ST elevation
Zone of Necrosis: Abnormal Q wave
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17. Sign and Symptom
Classic symptom of heart attack
are chest pain radiating to neck,
jaws, back of shoulder, or left arm
The pain can be felt like:
Squeezing or heavy pressure
A tight band on the chest
An elephant sitting on the chest
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18. Cont
Other symptoms
include:
Shortness of breath
(SOB)
Weakness and
tiredness
Anxiety
Lightheadedness
Dizziness
Nausea vomiting
Sweating, which may
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19. Collaborative Management
Assessment:
History
Clinical manifestation
Cardiovascular assessment
Laboratory assessment
Troponin T & I
CK-MB
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21. IMPORTANT INFORMATION TO
REMEMBER
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Increase supply of
Oxygen
Decreasing the demand of
Oxygen:
• Stop activity and lie down
(CBR)
•Take Tab. Angisid sublingually
and wait till it dissolves.
If pain continues take up to 03
Tab. Angisid one every five
minutes. If pain is not relieved
yet take another tab. and rush to
EMERGENCY services.
22. IMMEDIATE MANAGEMENT OF MI:
GOALS:
To prolong life.
Minimize infarct size.
Reverse ischemia.
Reduce cardiac work.
Prevent and treat complications.
A) INITIAL TREATMENT:
Rapid triage.
OMI (oxygen, monitor and I/V line).
Check vital signs and O2 saturation.
ECG within 10 minutes and repeat ECG.
Blood samples for enymes, CBC, lytes, and lipid
profile.
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25. Coronary Artery Bypass Graft surgery
(CABG)
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26. Nursing Diagnosis
Acute pain R/T imbalance between myocardial
oxygen supply and demand
Ineffective tissue perfusion R/T interruption of
arterial blood flow
Ineffective coping R/T effects of acute illness and
major changes in life style
Impaired gas exchange related to ineffective
breathing pattern and decreased systemic tissue
perfusion.
Anxiety related to present status and unknown
future, possible lifestyle changes, pain, and
perceived threat of death.
Activity intolerance related to fatigue
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27. Prevention
Recognize the symptoms
Reduce your risk factors:
Lose weight
Quit Smoking
Keep your cholesterol at a normal level.
Keep your blood pressure under control.
Use techniques to ease stress.
Control blood sugar level.
Eat Right
REGULER EXERCISE
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29. CARDIAC REHABILITATION:
Cardiac rehabilitation provides a venue for
continued education, re-enforcement of lifestyle
modification, and adherence to a comprehensive
prescription of therapies for recovery from MI,
which includes exercise training
Goals of Rehabilitation program:
Develop a program for progressive physical
activity
Lives as full, vital and productive life
Remain within the limits of the heart’s ability to
respond to increases in activity and stress.
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