MS LECTURE Acute Coronary Syndrome & Acute Stroke 10/04/24 PDF

MS LECTURE o Autoimmune ◼ Book based: Standard pathophysiology: October 4, 2024 lecture Week 8 ◼ Patient-based...

MS LECTURE o Autoimmune ◼ Book based: Standard pathophysiology: October 4, 2024 lecture Week 8 ◼ Patient-based: Modified pathophysiology: GCP Acute Coronary Syndrome and Acute Stroke Medicine vs Nursing Acute Coronary Syndrome Medicine ◼ #1 leading cause of mortality or death ◼ General knowledge in Doctor of Acute Stroke Medicine ◼ #2 disability ◼ Diagram accompanied by cellular biology, chemical reaction which is the Objectives: disease process, and trauma. ◼ To gain knowledge in immediate goals of o Disease process > COPD, TB, treatment for Acute Coronary Syndrome Pneumonia (ACS). Improved blood flow and restore o Trauma > stab wound, MVA the heart functions as much as possible ◼ Accompanied by drugs, labs, and ◼ Same with Acute Stroke, to minimize diagnostics, nutrition, other therapeutics brain injury and treat complications to ◼ Discipline/Specialty: IM, Surgery, restore client’s condition. Cardio, Nephro, OBGyne, Pedia, ◼ To maintain each immediate goals of Surgery, Fam Med treatment based on a given timelines of Nursing therapy. - EMS > Hospital > ◼ Disease process using a form of Nursing o 1 is ER > Stroke Center / Cath process. lab ◼ Assessment, Clinical manifestations o 2 is ICU which includes the signs and symptoms ◼ Nursing Diagnosis focusing on the client’s needs, prioritization based on clinical manifestations. o Concept Mapping o ABC, physiologic vs Pathophysiology psychosocial, Hierarchy of Needs ◼ Process of disorder focusing on the ◼ Nursing Management specific flow underlying mechanism causing abnormal charts of interventions like drugs, state treatments, therapeutics, diet therapy ◼ Physiologic state is affected > medical diagnosis Steps in Pathophysiology ◼ External – pathogens 1. Etiology (Risk factors) ◼ Internal – immune system - Non-Modifiable: Predisposing: o Immunodeficiency o Hypersensitivity  o Age – polypharmacy, o 2-3 columns, maximum of 5 with dependency, comorbid, sensory each pathogenesis impairment 4. Clinical manifestations (signs and o Genetics – family history symptoms) o Idiopathic – depression, - Signs – observed and detectable via autoimmune, unknown assessment - Modifiable (Precipitating): - Symptoms – experienced by the patient o Stress – sleep deprivation, pain or report / chief complaint o environment – secondhand - Each manifestation must have a nursing smoke diagnosis – Concept Map – applied thru o lifestyle – food intake prioritization o untreated preventable disease – - Major clinical manifestations yung UTI ilagay na lang 2. Pathogenesis – onset, develops due to - ABC to prioritize ilagay din certain etiology 5. Nursing Management - Exists before progression of disease - Concept Map process - Nursing Diagnosis – goals, expected - Trauma: initial diagnostic procedure > outcomes, interventions or evaluation, xray, MRI, CT scan o Promotion/Prevention - Each pathogenesis has its own disease o Rehabilitative process or branch o Curative o Example: Metastasis - Acute Coronary Syndrome - Manifestations - C- chest discomfort (pain) spreading to BSN: - Both arms or one arm o - Shoulder pain spreading into the back; - Atleast 1-3 rows, 1-3 columns stomach pain - The more mahaba ang patho, more - Neck pain starts to jaw tanong - Unexplained pressure or tightness in 3. Disease Process center of the chest lasting several - Body of pathophysiology minutes. - Progression and maintenance of disease - Lightheadedness or feeling dizzy nausea - Explanation of incubation period, and sweating prodromal period, period of illness, - Unexpected sudden shortness of breath convalescence to declining progress of - Center of the chest – levin’s signs > disease. clench fist chest Openhand chest > lungs - Body reaction – physiology vs Acute Coronary Syndrome pathophysiology o Increase and decrease Atherosclerosis – fat/plaque in artery - Lead to clinical manifestations – signs and symptoms - Sclerosis – narrowing or hardening - Effect of pharmacodynamics – movement of drugs sa katawan ng patient Pathogenesis Aerobic – cell/tissue 1. Damage to intima - Glucose + oxygen = ATP then converted - Sa sobrang lakas ng pressure (bp), to energy nabutas yung intima, nagleak then Cardiac Markers: Result magcclot over the time then kumapal, magfform ng thrombus or yung blood - MyOglobin: One hour result clot - TRoponin: Tres Three hours - History of hypertension - CK-Mb: Kuatro-sais 4-6 hours - aSt – 8 hours - LDH – day 24 hours or 1 day - Pinakaunang marker na gagawin is ECG - Clinical Manifestations of ACS 2. Cholesterol filled - Lumulutang na sebo, minsan nagdidikit Nursing Triage Management dikit , may transfat siya ◼ Assess ABCs and LOC - Hypercholesteremia ◼ Immediate Vital Sign - Hyperlipidemia ◼ Administer Oxygen if SpO2 ischemia (ischemic 2 Cells (irreversible) stroke) prolonged – long period onset - Heart muscle --- downtime / goal - Brain tissue ---- BE FAST o Titration +-5 o 50ml/hr maximum dose but start Nursing Triage Management at 20 ml/hr - 1st: Received EMS call o 2-3 readings - Assess ABCs and LOC o Every hour ang titrate depending - Immediate vital sign on the patient’s BP. - Administer oxygen if SpO2