Nursing Interventions Monitor continuous ECG Electrocardiography is the process of producing an electrocardiogram, a recording – a graph of voltage versus time – of the electrical activity of the heart using electrodes placed on the skin. These electrodes detect the small electrical changes that are a consequence of cardiac muscle depolarization followed by repolarization during each cardiac cycle. Changes in the normal EC…Electrocardiography
- Administer oxygen along with medication therapy to assist with relief of symptoms.
- Encourage bed rest with the back rest elevated to help decrease chest discomfort and dyspnea.
- Encourage changing of positions frequently to help keep fluid from pooling in the bases of the lungs.
What is the role of Nursing in the treatment of mi?
Nursing interventions are broadly designed to promote healing of the damaged myocardium, prevent complications (such as dysrhythmias, heart failure and shock), and facilitate the patient’s rapid return to normal health and life style. For the first few days after the onset of an MI the risk of sudden and unexpected death is high.
How do you deal with a patient with an mi?
Verbalize reduction of anxiety/fear. Demonstrate positive problem-solving skills. Identify/use resources appropriately. Identify and acknowledge patient’s perception of threat/situation. Encourage expressions of, and do not deny feelings of, anger, grief, sadness, fear. Coping with the pain and emotional trauma of an MI is difficult.
How do you assess for mi in nursing?
Nursing Assessment. One of the most important aspects of care of the patient with MI is the assessment. Assess for chest pain not relieved by rest or medications. Monitor vital signs, especially the blood pressure and pulse rate. Assess for presence of shortness of breath, dyspnea, tachypnea, and crackles.
What drugs are used to treat mi?
Morphine administered in IV boluses is used for MI to reduce pain and anxiety. ACE Inhibitors. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II to decrease blood pressure and for the kidneys to secrete sodium and fluid, decreasing the oxygen demand of the heart.
How do you treat a patient with a myocardial infarction?
Beta blockers, glyceryl trinitrate and possibly ACE inhibitors work in this way. All patients with a suspected myocardial infarction should be given aspirin. It is a powerful antiplatelet drug, with a rapid effect, which reduces mortality by 20%. Aspirin, 150-300 mg, should be swallowed as early as possible.
What should a nurse do if a patient has a heart attack?
Administer morphine sulfate (2 to 4 mg I.V. slow push every 5 to 15 minutes) for pain. Administer a lipid-lowering agent (such as 80 mg of atorvastatin) before PCI if the patient isn't on a statin. If the patient is on a statin, anticipate switching to atorvastatin 80 mg.
What is the first intervention for a patient experiencing an MI?
The first goal for healthcare professionals in management of acute myocardial infarction (MI) is to diagnose the condition in a very rapid manner. As a general rule, initial therapy for acute MI is directed toward restoration of perfusion as soon as possible to salvage as much of the jeopardized myocardium as possible.
What is the first intervention for a client experiencing MI?
The first goal for healthcare professionals in management of acute myocardial infarction (MI) is to diagnose the condition in a very rapid manner. As a general rule, initial therapy for acute MI is directed toward restoration of perfusion as soon as possible to salvage as much of the jeopardized myocardium as possible.
What is the best way to reduce myocardial oxygen consumption?
Beta-blockers:This group of drugs reduces myocardial oxygen consumption by lowering heart rate, blood pressure, and myocardial contractility. They block beta receptors in the body, including the heart, and reduce the effects of circulating catecholamines.
What is the pain of myocardial ischemia?
Myocardial ischemia can present as chest pain, upper extremity pain, mandibular, or epigastric discomfort that occurs during exertion or at rest. Myocardial ischemia can also present as dyspnea or fatigue, which are known to be ischemic equivalents.[14] .
Why do myocardial infarctions occur?
Most myocardial infarctions are due to underlying coronary artery disease, the leading cause of death in the United States. With coronary artery occlusion, the myocardium is deprived of oxygen. Prolonged deprivation of oxygen supply to the myocardium can lead to myocardial cell death and necrosis.[2] .
What are the nursing diagnoses for myocardial infarction?
Here are other nursing diagnoses you can use to make nursing care plans for myocardial infarction: Activity intolerance —imbalance between myocardial oxygen supply/demand. Grieving, anticipatory—perceived loss of general well-being, required changes in lifestyle, confronting mortality.
What is the cause of myocardial infarction?
Myocardial infarction is a part of a broader category of disease known as acute coronary syndrome, results from prolonged myocardial ischemia due to reduced blood flow through one of the coronary arteries. In cardiovascular diseases, the leading cause of death in the United States and western Europe usually results from ...
Symptoms
Levine’s Sign – Hand clutching over the chest. It is the universal sign for distress in heart attacks. It usually last for more than 30 minutes
Management
Antiplatelet agents: provides a strong mortality benefit, however, it also has a significant risk of bleeding in situation such as emergency coronary artery bypass graft (CABG).
Nursing diagnosis
Level I: Walk, regular pace, on level indefinitely; one flight or more but more short of breath than normally
Nursing diagnosis
Maintain hemodynamic stability, e.g., BP, cardiac output within normal range, adequate urinary output, and decreased frequency/absence of dysrhythmias.
Nursing diagnosis
Reduction/interruption of blood flow, e.g., vasoconstriction, hypovolemia/shunting, and thromboembolic formation
Nursing diagnosis
Verbalize understanding of condition, potential complications, individual risk factors, and function of pacemaker (if used).
How long does it take for myocardial infarction to start?
Onset of Myocardial Infarction may be sudden or gradual, and the process takes 3 to 6 hours to run its course. It is the most serious manifestation of acute coronary syndrome, a complication of coronary artery disease (CAD).
What is the best treatment for reperfusion arrhythmias?
Reperfusion arrhythmias may follow successful therapy. Beta-adrenergic blockers, to improve oxygen supply and demand, decrease sympathetic stimulation to the heart, promote blood flow in the small vessels of the heart, and provide antiarrhythmic effects. Calcium channel blockers, to improve oxygen supply and demand.
What is the goal of medical management?
Medical Management. The goals of medical management are to minimize myocardial damage, preserve myocardial function, and prevent complications such as lethal dysrrhythmias and cardiogenic shock. Oxygen administration is initiated at the onset of chest pain.
What is the most common presenting symptom of MI?
The most common presenting symptom of MI is chest pain, which is often described as severe retrosternal chest pain of a crushing or squeezing nature. Other clues to the differential diagnosis of chest pain are that the pain may radiate to the arms (commonly the left arm), shoulders, neck and/or jaw.
How long does it take to monitor a patient after MI?
This is usually due to a dysrhythmia and the patient will require continuous cardiac monitoring in coronary care for the first 24 to 48 hours.
Why does myocardial infarction occur?
Myocardial infarction (MI) occurs as a result of prolonged myocardial ischaemia that leads to irreversible injury and necrosis of myocardial tissue because of inadequate blood supply. For most people this occurs suddenly and is due to the rupture of an atheromatous plaque and the formation of a thrombus within the coronary circulation.
Why does MI happen suddenly?
For most people this occurs suddenly and is due to the rupture of an atheromatous plaque and the formation of a thrombus within the coronary circulation. Less common causes of MI include vasospasm of a coronary artery, which causes temporary occlusion of the artery lumen, or a sudden increase in oxygen demand such as a sustained rapid cardiac ...
How soon after MI can you give thrombolytics?
Giving thrombolytics (clot-dissolving drugs) as soon as possible after an acute MI reduces the risk of death and disability.
How long does it take for a patient to be ready for discharge?
From then on mobilisation is rapid and the majority of patients should be ready for discharge in five to seven days. Psychological support is another vital component of the nurse’s role as patients often experience fear and anxiety for the first few days after admission.
Is MI atypical or silent?
Groups of people more likely to have atypical presentation include women, individuals with diabetes, older people and people from minority ethnic groups (Department of Health, 2000).
What is MI in medical terms?
1. When MI is suspected to have occurred by a mechanism other than thrombotic occlusion at an atherosclerotic plaque. This would include coronary embolism, certain metabolic or hematological diseases, or coronary artery spasm.
How long does it take to take a syringe for MI?
1. For the first 24 to 48 hours in all patients with acute MI who do not have hypotension, bradycardia, or tachycardia. 2. Continued use (beyond 48 hours)* in patients with a large or complicated infarction.
How long should a patient be monitored for electrical shock?
The patient should be monitored closely for adverse electrical or mechanical events because reinfarction and death occur most frequently within the first 24 hours. The patient's physical activities should be limited for at least 12 hours, and pain and/or anxiety should be minimized with appropriate analgesics.
What is a spontaneous episode of myocardial ischemia?
1. Patients with spontaneous episodes of myocardial ischemia or episodes of myocardial ischemia provoked by minimal exertion during recovery from infarction. 2. Before definitive therapy of a mechanical complication of infarction such as acute mitral regurgitation, VSD, pseudoaneurysm, or LV aneurysm.
What is the best treatment for monomorphic ventricular tachycardia?
If monomorphic ventricular tachycardia is not accompanied by chest pain, pulmonary congestion, or hypotension, it should be treated with intravenous lidocaine, procainamide, or amiodarone. The patient with acute MI and symptomatic sinus bradycardia or atrioventricular block should receive atropine.