Myocardial infarction nursing care plan pdf paper
Dysrhythmias are usually treated symptomatically, except for PVCs, which are often treated prophylactically.
Chest pain nursing diagnosis care plan
ACS is usually triggered by the rupture of an atherosclerotic plaque in the wall of a coronary artery; this causes activation, adhesion and aggregation of platelets and the clotting systems, leading to the formation of a thrombus. Presence of hypoxia indicates need for supplemental oxygen. Some patients with nitrate-refractory pain receive opioids, such as intravenous morphine, at small doses every few minutes until they are pain free. Heparin This is an anticoagulant that breaks up blood clots as well as prevents them. Auscultate breath sounds. If the ECG is a normal sinus or otherwise non-concerning rhythm, place them on a 3 or 5 lead cardiac monitor for frequent re-assessing. GTN promotes venodilation and dilatation of the coronary arteries. Heart rate and rhythm respond to medication, activity, and developing complications. Desired Outcomes Maintain hemodynamic stability, e. Caffeine is a direct cardiac stimulant that can increase heart rate. Nursing Times [online]; 3, Box 1. Oxygen Patients with acute chest pain and presumed ACS do not need oxygen unless they present with hypoxia or heart failure. Pacing may be a temporary support measure during acute phase or may be needed permanently if infarction severely damages conduction system, impairing systolic function. Honest explanations can alleviate anxiety.
The resulting ischemia restriction in blood supply and ensuing oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death infarction of heart muscle tissue myocardium.
Accurate information about the situation reduces fear, strengthens nurse-patient relationshipand assists patient and SO to deal realistically with situation.
Shortness of breath, palpitations, syncope or autonomic symptoms such as sweating, nausea, tachycardia or vomiting may also occur with or without chest pain. Demonstrate an increase in activity tolerance.
Nursing care plan for myocardial infarction scribd
Understanding the diagnostic approaches, as well as pharmacological and coronary interventions is crucial, given the prevalence of ACS. You are here: Clinical zones Review Diagnosis, management and nursing care in acute coronary syndrome 13 February, Acute coronary syndrome is a potentially life-threatening condition associated with coronary heart disease. Confrontation can promote anger and increase use of denial, reducing cooperation and possibly impeding recovery. Measure cardiac output and other functional parameters as appropriate. This article discusses current evidence-based guidance in the management of ACS and the critical role of nurses. Crackles reflecting pulmonary congestion may develop because of depressed myocardial function. Pathophysiology Most ACS cases are caused by atherosclerosis, which takes place in the coronary arteries, often decades before a cardiac event. Intervention can help patient regain control of own behavior. Maintain IV or Hep-Lock access as indicated. Irregularities suggest dysrhythmias, which may require further evaluation and monitoring. May reflect pulmonary edema related to ventricular dysfunction. Compare both arms and obtain lying, sitting, and standing pressures when able. Large meals may increase myocardial workload and cause vagal stimulation, resulting in bradycardia or ectopic beats.
Provide privacy for patient and SO. Nurses receiving these patients need clear information about the type of procedure they had, any complications, medications and IV fluids, and whether they have received anticoagulants or GPIs, which will put them at greater risk of bleeding Macdonald et al, If the thrombus completely occludes the coronary artery, the section of the myocardium supplied by that artery is starved of oxygen, leading to myocardial cell necrosis, and typical ST elevation changes are seen on an electrocardiogram Fig 1.
Monitor heart rate and rhythm. Myocardial infarction most commonly due to occlusion blockage of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids cholesterol and fatty acids and white blood cells especially macrophages in the wall of an artery.
Give 0. Evaluate quality of pulses on both pulse points.
This can compromise the myocardium, leading to reversible ischaemia or a complete loss of blood supply, which in turn leads to myocardial infarction and ultimately myocardial cell death necrosis. Heart rate and rhythm respond to medication, activity, and developing complications.
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