Archive:Acute coronary syndrome orders: Difference between revisions
wikademia>Koppertone |
wikademia>Koppertone No edit summary |
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==Vitals== | ==Vitals== | ||
*[[ | *[[Wikipedia:Telemetry#Medicine|telemetry]] | ||
*continuous monitoring ECG | *continuous monitoring ECG | ||
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*fasting lipid profile in AM | *fasting lipid profile in AM | ||
*HgBA1C for diabetics | *HgBA1C for diabetics | ||
*fasting [[ | *fasting [[wikipedia:Homocysteine|homocysteine]] | ||
*HgB, plt q2d (for patients on unfractionated) | *HgB, plt q2d (for patients on unfractionated) | ||
| Line 38: | Line 38: | ||
*catheter lab (door to balloon time < 90 minutes) | *catheter lab (door to balloon time < 90 minutes) | ||
*thrombolytic therapy as per Acute MI protocol (if STEMI) (< 30 minutes) | *thrombolytic therapy as per Acute MI protocol (if STEMI) (< 30 minutes) | ||
*[[ | *[[wikipedia:Clopidogrel|Clopidogrel]] 600 mg po STAT, then Clopidogrel 75 mg po qd | ||
*[[ | *[[wikipedia:Enoxaparin|enoxaparin]] 1 mg/kg sc q12h to a max of 100 mg/dose | ||
'''↓O2 NEED''' | '''↓O2 NEED''' | ||
*[[wikipedia:Metoprolol|metoprolol]] 5 mg IV q5 min x 3; followed by 25 mg po q6h x 48h, then 100 mg po q12h | *[[wikipedia:Metoprolol|metoprolol]] 5 mg IV q5 min x 3; followed by 25 mg po q6h x 48h, then 100 mg po q12h | ||
*[[ | *[[wikipedia:Ace inhibitor|ACEi]] | ||
==Maintain== | ==Maintain== | ||
Revision as of 22:43, 19 May 2007
Admission
Admit to Dr. _________
Diet
- cardiac diet
Activity
- bed rest
Vitals
- telemetry
- continuous monitoring ECG
Investigatiosn
- Routine - CBCD
- renal → creatinine, lytes, total protein, Mg, urine analysis
- liver → albumin, PT, ALKP, ALT, bilirubin
- CXR daily x 3 days
Acute Coronary Syndrome
- CK q8h (x 5 for MI, x3 to rule out MI)
- troponin I q8h
Cardiac
- fasting lipid profile in AM
- HgBA1C for diabetics
- fasting homocysteine
- HgB, plt q2d (for patients on unfractionated)
Drugs
MONA
- Morphine
- Oxygen at 3L/min by NC prn, titrate to saturation >90%
- Nitrate therapy IV (25 mg in 250 mL D5W) or NG patch
- ASA 160 mg po chew and swallow, then enteric coated ASA 81 mg po qd
Blood
- catheter lab (door to balloon time < 90 minutes)
- thrombolytic therapy as per Acute MI protocol (if STEMI) (< 30 minutes)
- Clopidogrel 600 mg po STAT, then Clopidogrel 75 mg po qd
- enoxaparin 1 mg/kg sc q12h to a max of 100 mg/dose
↓O2 NEED
- metoprolol 5 mg IV q5 min x 3; followed by 25 mg po q6h x 48h, then 100 mg po q12h
- ACEi
Maintain
- lipitor
- cardiac rehabilitation to see
- NG 0.3 mg SL PRN
Other OSCE Modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence