الأحد، 26 أغسطس 2018

162-Myocardial Infarction

About
"Heart Attack" causing a disruption of blood flow and oxygen to myocardial tissue, potentially causing tissue necrosis or death.
Assess
Pain ( tightness, burning, pressure, heartburn, radiating, neck, jaw, chest, back); VS, heart rhythm ( arrhythmia, presence of s4), anxious, cool, diaphoretic, lung sounds ( crackles, dyspnea)
Complications
Death, hypoxemia, anoxia, hypoxia, heart failure
Diagnosis
  • Acute pain related to tissue ischemia
  • Ineffective tissue perfusion related to interruption of myocardial blood flow
Goals
  • The client will be free from pain.
  • The client will verbalize understanding of treatment plan.
  • The client will have adequate oxygenation.
Interventions
  • Maintain NPO prior to surgery and start with clear liquids after surgery.
  • Monitor electrolytes, cardiac enzymes, intake and output, ECG, pain, pulse oximetry, fluid balance, circulation, and breath sounds.
  • Monitor onset, location, precipitating factors, alleviating factors, intensity of chest pain.
  • Prepare for procedures ( CABG, cardiac cath, angioplasty, etc.) as indicated.
  • Teach client non-pharmacological treatments including low sodium, low fat, low cholesterol diet, exercise, weight reduction, smoking cessation, avoiding alcohol.
  • Teach client about medications including rationale, side effects, dosing schedule.
  • Teach client how to monitor blood pressure and when to seek follow-up treatment.
  • Teach client about disease and its effects on other body areas and s/s of complications.
  • Teach client how to use AED if candidate for having one in the home.
  • Begin cardiac rehabilitation as ordered.
  • Monitor for signs/ symptoms of complications.

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