Heart Lung 14 3: An intravenous line is established and blood samples are obtained for CBC, BUN, glucose, electrolytes, calcium, and cardiac enzymes. Weller DM, Noone J: The lead ECG should be recorded quickly and cardiac monitoring initiated at once. Major contraindications to the use of streptokinase are recent strep infections, recent intracranial or intraspinal surgery or trauma, intra-cranial aneurysm. Cocaine is classified as a local anesthetic and sympathomimetic drug. The patient who is experiencing acute myocardial ischemia or infarction related to cocaine use should be recognized and managed as any other patient with myocardial ischemia precipitated by other factors such as arteriosclerosis and vasospasm. The cardiac impulse travels down the conduction system, back up. BP may be reduced related to the ongoing ischemia that is reducing myocardial contractility or the increased preload that is reducing myocardial pump efficiency.
Mark's preexisting history of hypertension may be aggravated by the use of cocaine. Rick is assisted with lying supine on a stretcher. Asystole and ventricular fibrillation associated with cocaine intoxication. The patient may progress very rapidly from advanced stimulation to significant depression of the CNS within a very brief period of time Rosenburg J, Becker CE: Heart Lung 14 4: As the plasmin circulates through the body. Major contraindications to t-PA are similar to those for other thrombolytic agents. Unaccustomed overexertion of muscles leads to rhabdomyolysis damage to muscle most often seen in new army recruits. Rick tells the triage nurse, ' 'My heart's pounding so fast. Emerg Med 20 7: In individuals with heart disease, exercise interventions lower blood levels of fibrinogen and C-reactive protein, an important cardiovascular risk marker. A brief description of the pathophysiology of WPW syndrome should be shared with Rick and written on paper for Rick to carry with him. Cocaine is rarely taken orally because minimal absorption occurs in the GI tract due to the acidity in the stomach. Because the a-adrenergic effects of vasoconstriction are left unopposed when propranolol is used, some authors recommend the use of a-adrenergic blocking agents such as phentolamine, or afterload reducing agents such as sodium nitroprusside Intravenous procainamide should be used for patients with WPW and atrial fibrillation. If Rick had been on any antiarrhythmic medications or theophylline. Noncompliance related to follow-up care with known cardiac condition Desired patient outcome: In addition, as the person reaches tolerance for increasing dosages of the drug, the individual may crave more drug even though plasma concentrations remain elevated Orienting Mark and his wife to important significant events of the upcoming hospitalization are indicated. During these processes, the protein troponin increases in the bloodstream, indicating cardiac muscle cell death and increased stress on the heart itself. Patients presenting with chest pain must be carefully screened and evaluated according to the above criteria. Heart Lung 17 2: However, there are additional challenges due to the direct effect of the drug on the CNS. The patient is escorted immediately to the treatment area. The cardiac impulse travels down the conduction system, back up.
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