MONA

although the aha coined the acronym mona, this was not a recommendation that this be the ordered that the interventions were applied. if you review the 2005 american heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 8: stabilization of the patient with acute coronary syndromes the administration of these 4 medications is discussed in several sections.

the following was copied from the acute coronary syndromes algorithm:

ems assessment and care and hospital preparation:

- administer oxygen, aspirin, nitroglycerin, and morphine if needed.

immediate ed general treatment

- start oxygen at 4/min; maintain o2 sat >90%

- aspirin 160 - 325 mg (if not given by ems)

- nitroglycerin sublingual, spray, or iv

- morphine iv if pain not relieved by nitroglycerin

the following was copied from initial general therapy for acs section:

morphine sulfate: morphine sulfate is the analgesic of choice for continuing pain unresponsive to nitrates, and it is also effective in patients with pulmonary vascular congestion complicating acs. morphine is a venodilator that reduces ventricular preload and oxygen requirements. for this reason it should not be used in patients who may have hypovolemia. if hypotension develops, elevate the patient's legs, administer volume, and monitor for signs of worsening pulmonary vascular congestion. start with a 2 to 4 mg iv dose, and give additional doses of 2 to 8 mg iv at 5- to 15-minute intervals

furthermore, in 3 years in the emergency department as well as 3.5 years doing critical care transport, i have never administered morphine as the first intervention, nor have i ever heard of it being done.

i hope this information is helpful.

:yeah:, wow! good explanation! maybe the arguments will then be end???

yeah! really confusing, our clinical instructor told us that it's up to us to think and evaluate about mona because different books and authors has their own condicting/opposite ideas.

thanks chare!!!:bowingpur:bow::bowingpur

Hey I was wondering what you meant by this.

"For my own little understanding and opinion, i would say the answer is (2), if there's no continuation of "few distractions". Hence, that makes wrong (2), because it is not really/fully a safe environment." I figured fewer distractions would be good, sounds like you're saying fewer is bad.

I don't have my old NS books for reference. I can just tell you what we do in real life.

Many, many times pts with CP have NOT received MS. That's because the NTG worked.

So, in order for us, in the ICU (the ASA has already been given)

O2

NTG

Then MS if pain is not relieved.

But, come on...O2 is the priority-always.

Someone should tell Kaplan that.

Hey I was wondering what you meant by this.

"For my own little understanding and opinion, i would say the answer is (2), if there's no continuation of "few distractions". Hence, that makes wrong (2), because it is not really/fully a safe environment." I figured fewer distractions would be good, sounds like you're saying fewer is bad.

Accdg to Saunders strategy, a little wrong words included in the correct answer, then that will make the WHOLE sentence WRONG.....it's a Distraction!

if we consider SAFETY is the first PRIORITY, then SAFETY in all the way is important, not half safety or few safety (few distractions).

Does this make sense?????

I mean 100% SAFETY without any distractions!

Oooh so you meant if it said with NO distractions, then it would be correct. But the fact it only says few or something, then there are still distractions present. Haha sorry I was tired last night.

Oooh so you meant if it said with NO distractions, then it would be correct. But the fact it only says few or something, then there are still distractions present. Haha sorry I was tired last night.

Absolutely! i understand that we been studying very hard for the preparation of our big day! That's really happen if we are tired or lack of sleep. GOD BLESS!

Don't take anyone's word for it, reference the literature. Evidence based practice is essential to providing consistent and safe care.

American Nurse Today states "But keep in mind that while MONA might be easy to remember, the drugs aren't given in the MONA sequence. They're given in the order of OANM."

Emergency cardiac drugs: Essential facts for med-surg nurses

Issue Date: July 2010 Vol. 5 No. 7

Author: Ira Gene Reynolds, MSNEd, RN, PCCN-CMC