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This Concept Map, created with IHMC CmapTools, has information related to: Acute MI2, ???? leads to Medical diagnosis Acute Myocardial Infarction (Ant/septal), Monitor reperfusion and SE of Thrombolytics -cardiac monitoring -ECG (ST changes) -V/S Q 15 min -Neuro V/S Q 15 min -s&s of bleeding (ref needed) leads to diagnosis of ACS-STEMI (ant. wall) Killip III, Blood results -Trop 7.7 -CPK 1433 -CK-MB 197 no renal failure leads to diagnosis of ACS-STEMI (ant. wall) Killip III, Xray=mod pulmonary edema requires Monitor In/Outs, ACS-STEMI (ant. wall) Killip III necessitates immediate transfer for Rescue PCI, Monitor ABCs -Resp rate/effort -SpO2 95% on 5L/min NP -mod. crackles lower 1/3 lungs -no JVD/HJR requires Administer Diuretic -Lasix 40 mg IV (?more) -Foley inserted, ACS-STEMI (ant. wall) Killip III requires Ongoing Monitoring of VS, CP and S&S of bleeding enroute to tertiatry hospital, Monitor ABCs -Resp rate/effort -SpO2 95% on 5L/min NP -mod. crackles lower 1/3 lungs -no JVD/HJR leads to diagnosis of ACS-STEMI (ant. wall) Killip III, Administer Reperfusion Therapy as indicated -TNK 50 mg IV -Heparin 4,000 units IV bolus -Heparin 12 u/kg requires Monitor reperfusion and SE of Thrombolytics -cardiac monitoring -ECG (ST changes) -V/S Q 15 min -Neuro V/S Q 15 min -s&s of bleeding (ref needed), ???? completes Triage nurse assesses -assess S&S of STEMI -12 lead ECG -brief, targeted Hx (ACC/AHA Guidelines), Rescue PCI nusing care for Prep for PCI -shave groin -pain control -VS monitoring -cardiac monitoring -S&S bleeding, ???? requires Monitor ABCs -Resp rate/effort -SpO2 95% on 5L/min NP -mod. crackles lower 1/3 lungs -no JVD/HJR, ER Nurse Initiates -cardiac monitor -Oxygen therapy -IV D5W x 2 -Blood studies -NTG (sublingual) -Aspirin (chewable) (ACC/AHA guidelines) lab results Blood results -Trop 7.7 -CPK 1433 -CK-MB 197 no renal failure, Monitor ABCs -Resp rate/effort -SpO2 95% on 5L/min NP -mod. crackles lower 1/3 lungs -no JVD/HJR requires Monitor In/Outs, Xray=mod pulmonary edema requires Administer Diuretic -Lasix 40 mg IV (?more) -Foley inserted, Mr. X 50 y.o. engineer has risk factors 2PPD smoker BMI=33 Age=50 ?Stress level ?family Hx, Mr. X 50 y.o. engineer lives with family Wife son daughter, ???? ongoing assessment Monitor Chest Pain and BP -titrate NTG gtt to pain relief and maintain syst BP mmHg -?Morphine 5 mg IV prn -5/10 pain persists, Triage nurse assesses -assess S&S of STEMI -12 lead ECG -brief, targeted Hx (ACC/AHA Guidelines) Mr. X to acute area and call for ACT team ????, Mr. X 50 y.o. engineer has symptoms of Chest pain at home with n & v and SOB