Toxins damage the tunica interna of endometrial cells

Plaque formation (fat, cholesterol,

protein, Ca, and WBC)

partial blockage in coronary

arteries

rupture of plaque

Platelets adhere to the cheesy

filling of plaque

enhance clotting process

complete occlusion of
coronary artery

lack of O2 supply to myocardium’s zone of perfusion

SUB ENDOCARDIAL INFARCT (NSTEMI)- 1/3 TRANSMURAL INFARCT (STEMI) -

WHOLE
DEFINITION ASSESSMENT

- an area of the myocardium is permanently destroyed, typically RISK FACTORS CARDIO

because plaque rupture and subsequent thrombus formation result in  chest pain/discomfort
 Hypertension
complete occlusion of the artery  murmur
 age: 45 (M); 55 (F)
TYPES:   jugular venous distention
  blood cholesterol
1. STEMI- Coronary artery is completely blocked  hypertension (sympathetic stimulation
2. NSTEMI- 1/3 blocked of coronary rtery  drug substance use (cocaine)
or hypotension ( contractility,
 stress
cardiogenic shock, medications
 history
NURSING INTERVENTIONS  irregular pulse (atrial fibrillation)
 obesity
 dysrhythmias (e.g.
 Administer supplemental oxygen, as indicated.  tobacco smoking tachycardia/bradycardia)
 Assess for Homans’ sign (pain in calf on dorsiflexion), RESP
erythema, edema.  shortness of breath, dyspnea,
 Measure I&O, noting decrease in output, concentrated tachypnea, crackles (pulmonary
appearance. Calculate fluid balance. congestion
ACUTE MYOCARDIAL  pulmonary edema
 Support normality of grieving process, including time
INFARCTION GI
necessary for resolution.
 nausea & vomiting
NURSING DIAGNOSIS GU
DRUGS  urinary output (cardiogenic shock)
 Ineffective cardiac tissue perfusion related to reduced  thrombolytic- prevent SKIN
 coronary blood flow further clot formation  cool, clammy, diaphoretic, pale
 Risk for imbalanced fluid volume  analgesic (morphine)- (sympathetic stimulation=
 Risk for ineffective peripheral tissue perfusion related reduce pain & anxiety, cardiogenic shock
 to decreased cardiac output from left ventricular decreases workload of the NEUROLOGIC
 dysfunction heart and relaxes  anxiety, restlessness,
 Death anxiety related to cardiac event bronchioles to enhance lightheadedness (sympathetic
 Deficient knowledge about post-ACS self-care oxygenation stimulation/  contractility & cerebral
 IV Beta-blocker- decrease O2; cardiogenic shock)
incidence of future cardiac PSYCHOLOGICAL
LABORATORY/ DIAGNOSTIC TESTS
events  fear w/ feeling of impending doom
 ECG- assists in ruling out/ diagnosing an AMI
 nitroglycerin- causes  denial
 CT SCAN/ MRI
vasodilation and increases
 Echocardiogram- evaluate ventricular function
blood flow to the
 Cardiac enzymes & biomarkers MEDICAL MANAGEMENT
myocardium.
o CK-MB- elevated = AMI  Percutaneous Transmural Coronary Angioplasty (PTCA) - used to
 ACE inhibitors- blood open the occluded coronary artery and promote reperfusion to the
o Myoglobin- heme protein that transport O2 in
pressure decreases, area that has been deprived of oxygen.
cardiac musle; negative results rule out AMI
dieresis, decreasing O2
o Troponin I- protein in myocardium, regulates the  Coronary Artery Bypass/ Minmially Invasive Direct Coronary Artery
demand of the heart
myocardial contractile process; elevated= AMI Bypass (MIDCAB)
 O2 administration