Deficits in nursing knowledge related to the assessment of injury and ischemia based on changes in ST segments and T waves have been documented. Continuous ST segment monitoring is clearly indicated in many areas: ruling out myocardial infarction, evaluating patients with known or suspected coronary artery disease, evaluating reperfusion after thrombolytic therapy, evaluating post-MI ischemia, evaluating reocclusion after angioplasty or atherectomy, evaluating myocardial ischemia as the. 33,34 Accurate ST-segment monitoring requires nurses to have a high level of knowledge and skill for accuracy and for effective clinical decision-making. 2,4,5,16-32Ī lack of awareness is apparent with respect to recommendations for ST-segment monitoring, and ST-segment monitoring is underused in clinical practice.
every 20 minutes or continuously for 1 hour (iv) Monitor closely for adverse effects such as. Ischemia is present in hospitalized patients with acute coronary syndrome (ACS, unstable angina) and is also potentially present in noncardiac critically ill patients and in patients undergoing noncardiac surgery who have coronary disease or cardiac risk factors. The ICM documented a 28 incidence of new-onset atrial fibrillation, a 13 incidence of nonsustained ventricular tachycardia (16 beats), a 10 incidence of high-degree atrioventricular block, a 12 incidence of significant sinus node disease, a 3 incidence of sustained ventricular tachycardia, and a 3 incidence of ventricular fibrillation. Elevation of head of bed to 30 to 45 degrees overbed table. 7-15 Although the evidence supports the treatment of detected myocardial ischemia, no randomized clinical trials have been done to test the effect of continuous ST-segment monitoring on clinical outcomes.
1-6 Changes in the ST segment also add prognostic information that can potentially influence treatment decisions. An EKG shows the rhythm on the screen that the wires are connected to.
ST-segment monitoring can enable the detection of silent ischemia and result in changes in clinical management. ST segment monitoring is done using a heart monitor or electrocardiogram (EKG ).
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