Presentation PTCA

A PRESENTATION OF PTCA FOR NURSES

1. MELVIN PIOUS

2. Risk factor

3. Chest pain Severe and prolonged and may be described as crushing, constricting, or oppressive. Radiation of pain to ulner aspect of left arm, neck, jaw and Interscapular region. Clinical Manifestations

4. ASSESSMENT

5. History Taking. Physical Examination Vital parameters 12 lead ECG monitoring. Measure oxygen saturation. Obtain initial serum cardiac markers Nursing Assessment in Emergency Room

6. IMMEDIATE GENERAL MANAGEMENT Oxygen at 4 l/min. Aspirin 160-325mg. Nitroglycerine SL or spray. Morphine IV Memory Aid: ‘MONA ’ NOW “ONAM”

7. 1 .Assess and document the chest Pain. 2 . Assess vital parameters. 3 . Obtain 12 lead ECG. 4 . Assess cardiac marker values. 5 .Report the findings of assessment to physician. Interventions Interventions

8. 6 Administer oxygen, morphine sulfate, nitroglycerine or other medications as ordered. 7 Provide the restful environment and promote the patient’s comfort. 8 Provide care in calm, competent manner.

9. MEDICAL INTERVENTION Start two IV lines. Administer adjunctive medications :

10. Early reperfusion

11. Administer thrombolytic therapy as prescribed. Streptokinase Urokinase T PA( Tissue plasminogen activator) Door to drugs: <30min .`

12. Prepare for Primary PCI as prescribed. Door to balloon 90+ 30 min .

13. pROFILE CBC, KFT, LFT, PT-INR, APTT, VIRAL MARKER, BLOOD GROUPING & Rh factor RANDOM BLOOD-SUGAR ECG , ECHO-Screening, CHEST X-RAY.

14. S OF PTCA