Pharm Study Guide (Management of ST-Elevation Myocardial Infarction) Ch 53

IV morphine 4 mg is prescribed for a STEMI patient. Available is 5 mg/mL. How many mL of morphine should be administered?

0.8 mL

What is an expected response within minutes of administering IV morphine during STEMI?

Decrease in pain and BP

Which drug prescribed for acute STEMI should be withheld and the prescriber consulted immediately if the patient's pulse is 118 beats/min?

Nitroglycerin

Current recommendations for MI include administering oxygen if O2 sats are less than ___________

90%

When caring for a patient during STEMI who is prescribed alteplase, the nurse would question the prescriber if which drug was also prescribed?

Abciximab (ReoPro)

The drug book suggests diluting morphine to 4-5 mL and infusing over 4-5 minutes. To push a tenth of a mL every 5 seconds, the nurse would add how much sterile diluents to the 0.8 mL of morphine and push over what time?

Adding 4.2 mL of diluent for a total of 5 mL and pushing 0.1 mL every 5 seconds will result in completing the drug in 4 minutes and 10 seconds

Research suggests that which treatment improves outcomes in STEMI?

Administration of aspirin, a beta blocker, morphine, and nitroglycerin

Risk factory for ATEMI include ___________, __________, _________, _________, ___________, ______________, and ___________

Advanced age; family history of MI; sedentary lifestyle; high serum cholesterol; hypertension; smoking; diabetes

Remodeling of the myocardium that occurs with MI is mediated by __________

Aldosterone

Almost all coronary occlusions occur at the site of a ruptured _______ ________

Atherosclerotic plaque

The ED triage nurse answers the call of a patient who has a history of angina pectoris and COPD. The patient reports chest pain that has not been relieved by 3 doses of nitroglycerin. The patient had been told by his physician that he should take chewable aspirin should this occur, but he does not have any aspirin. What should the nurse tell the patient to do?

Call 911

A protocol in the ER is to administer 4 chewable 81 mg aspirin tablets (total 324 mg) to patients with suspected MI. A student nurse asks the nurse why 4 chewable aspirin tablets are administered instead of 2 regular aspirin tablets (650 mg). What is the most accurate explanation for this protocol for the first dose of aspirin?

Chewable forms of aspirin are absorbed through the buccal mucosa bypassing hepatic first pass

The medical term for a heart attack is ________ ________

Myocardial infarction

Because of the impairment in blood flow and resulting acidosis with STEMI, the nurse would expect the patient to exhibit...

Rapid, deep respirations

The nurse knows that nitroglycerine decreases the workload of the heart by doing what?

Reducing venous return to the heart

The "ST" in STEMI stands for the elevation of the _____ _________ of the PQRST of the ECG

ST segment

Myocardial infarctions where there is partial blockage of the coronary artery are called non _____________ MI

ST-elevation

The abbreviation for an MI with complete blockage of the coronary artery is ________

STEMI

Intracellular proteins released when cardiac muscle cells are damaged are called ________

Troponins

A patient who is undergoing an acute ST elevation MI (STEMI) is prescribed metoprolol 50 mg by mouth every 6 hours. It would be a priority to immediately contact the prescriber if which assessment finding was present?

Wheezing

Which lab result in the history of a patient who is experiencing STEMI would be most important to report to the prescriber who has just ordered captopril (Capoten)?

eGFR 8 mL/min