CASE STUDY: Acute Anterolateral Myocardial Infarction
- List Patient A’s major risk factors for CHD and discuss other possible risk factors for heart disease.
- Discuss the pathophysiology of CHD and the signs and symptoms (i.e., classic physical exam findings) exhibited by the acutely ill patient during an MI. What are the common complications post-infarction?
- What patient history points indicate the diagnosis of MI in Patient A’s case?
- Correlate the pathology, complications, and nursing care for a patient with MI with the patent’s progress from the CCU to home.
- Review the action, side effects, and specific nursing care for the drugs commonly used in the treatment of patients with MI, including:
o Analgesics (e.g., morphine)
o Sedatives (e.g., phenobarbital)
o Antianxiety medications (e.g., diazepam)
o Anticoagulants (e.g., heparin)
o Laxatives/stool softeners
o Vasopressors (e.g., norepinephrine)
o Vasodilators (e.g., nitroglycerin)
o Diuretics (e.g., furosemide)
o Cardiotonics (e.g., digoxin)
o Cardiac stimulants (e.g., epinephrine, isoproterenol)
o Cardiac depressants (e.g., amiodarone)
o Antilipidemic drugs (e.g., atorvastatin)
- Describe the treatment for MI.
- What diagnostic tests usually confirm an MI?
- Nursing care of the patient with MI is directed toward detecting complications, preventing further myocardial damage, and promoting comfort, rest, and emotional well-being. Discuss the specific care needs for each situation listed below:
o On admission to the CCU
o During episodes of chest pain
o Fluid retention
o Rest
o Elimination
o Exercise and immobility
o Psychologic stress
o Patient teaching and discharge panning for a cardiac rehabilitation program
- Psychologic support is imperative for the well-being of the patient with MI. Discuss the patient’s potential anxieties and fears and the best means to provide realistic emotional support and reassurance.
- Should Patient A make specific lifestyle changes? If so, what changes and how can these be encouraged?
