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NCLEX Topics
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MI and MONA?
The acronym MONA is helpful to remember the key component, but be aware that MONA doesn't indicate the ORDER in which these things are done!
✔️Oxygen if needed (most likely will be!)
✔️Aspirin if not already given.
✔️Nitroglycerin sublingual or translingual spray. It’s important to note that you’ll want to look at the ECG before giving the NTG; this is because it’s not recommended in right-ventricular infarct. In right heart failure, the heart needs MORE preload, not less. Your patient with a right ventricular infarct needs that preload because the right side of their heart is not working well.
✔️Narcotic such as morphine, if the pain does not resolve with NTG administration. If NTG relieves the pain, this could mean that the arteries have opened and the heart is getting oxygen; if the NTG doesn’t help, it’s generally a sign that things are very serious. The M in MONA stands for morphine as it’s generally considered the drug of choice.
The acronym is more like ONAM or OANM…depending on when your hospital protocol dictates giving the nitro vs the aspirin.
🌟BUT the American Heart Association (AHA) recommends that a client having chest pain chew two baby aspirins or one 325-mg tablet immediately to help prevent platelet aggregation and further extension of a coronary thrombosis.
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