Get this App offline and editable on your phone

iPhone & iPad | Android | PC | Mac

NSTEMI

  • NSTEMI, unstable angina

  • Admission orders

    • Admit: CCU or step-down, Telemetry
    • Diagnosis: NSTEMI
    • Condition: Guarded
    • Vital Signs: Unit routine
    • Allergies: Bedrest
    • Nursing:
      • glc before each meal and qhs
      • O2 2L per NC, increase to keep sat > 93
      • guaic all stools
    • Diet: Heart Healthy Diet
    • Activity:
    • Labs:
      • EKG on admit, and for recurrent chest pain
      • enzymes: CK-MB, troponin
      • CBC, chem qd
      • coags: PT, PTT
      • lipid panel: cholesterol, HDL, LDL
    • IV: Saline Lock
    • Special:
      • cardio consult
    • Medications:
      • Aspirin 325 mg PO qd, first now if not already given
      • Clopidogrel 300 mg now then 75 mg PO qd
      • Enoxaparin 1 mg/kg SQ q 12 hours
      • Metoprolol 50 mg PO q 12 hours - first dose now. Hold for SBP < 100 mmHg, HR < 50 bpm, and call MD
      • Nitroglycerin 0.4 mg SL prn chest pain; may repeat in 5 minutes
      • Morphine sulfate 1-4 mg IV q 5 minutes prn chest pain, not to
  • Exceed 10 mg in 1 hour. Hold for sedation, RR < 10, or SBP < 90

  • Discharge

    • education
      • nutritionist
      • smoking cessation
      • activity level
      • meds
    • meds
      • A beta blocker
      • Aspirin
      • A statin
      • An ACEI for those with LV dysfunction or inadequate BP control on beta blocker
      • For most patients, especially if a stent has been placed, clopidogrel
    • f/u 1-4 weeks
    • activity

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.