Jumat, 24 Oktober 2008

MYOCARDIAL INFACTION IN NURSING CARE PLAN

Nursing care plan to the patients with Myocardial Infarction. Patients who suffer Myocardial Infarction they have many symptom include chest pain, shortness of breath, nausea, vomiting, palpitations, sweating, and anxiety or a feeling of impending doom. In physical examination to the patient with Myocardial Infarction cases appear some of general symptom like comfortable, or restless and in severe distress with an increased respiratory rate.

The Nurse in medical care to take an action as nursing intervention they will collecting data and priority nursing care plane according to the patients condition. This is some nursing care plan (NCP) for patients with Myocardial Infarction related to patient condition :



1. Nursing care plan for chest discomfort (pain) due to an inbalance Oxygen (O2) demand supply.
- Asses the severity, location & duration of pain (report)
- Administer O2 with semi-fowler's position
- Obtain a 12 lead ECG during pain
- Monitor vital signs
- Administer Nitroglycerine & Narcotic analgesics as ordered
- Administer & Monitor Thrombolytic therapy
- Ensure rest & sleep, provide a comfortable environment
- Monitor patient's response to drug therapy

2. Nursing care plan for potential Arrhythmias related to decrease cardiac output.
- Monitor cardiac rate, rythm & conduction (report any change)
- Observe vital signs, ECG, urine output, skin temp & colour
- Administer prophylactic anti-arrhythmic & other drugs as ordered
- Administer IV fluids
- Promote physical & mental rest & comfort
- Monitor laboratorium result
- Keep anti-dysrhythmic drugs & defibrillator ready

3. Nursing care plan for respiratory difficulties (dyspnoea) due to decrease CO
- Asses for any dyspnoea, abnormal breath sound (report)
- Ensure propped up position, rest & comfort
- Administer O2 & drugs as ordered
- Psycological support, give liquid diet

4. Nursing care plan for anxiety & fear of death
- Encourage patient & family to express fear or anxiety by interest, listening, caring
- Explain the procedures being done on him
- Psycological & spiritual support
- Administer morphine or other anti-anxiety drug

5. Nursing care plan for activity intolerance related to limitations imposed by Myocardial Infarction
- Explain to the patient if he need Bed rest to decrease O2 consumption
- give liquid diet & stool softners to avoid constipation
- help for personal hygienic activity
- Watch for dyspnoea, chest pain during activity
- Administer O2 as needed

6. Nursing care plan for potential for complications of thrombolytic therapy
- Watch for sign & symptom of bleeding, arrhythmias ect
- Fix cannula for IV medication & blood collection
- Protect patient from any injury
- Monitor bleeding time & coagulation profile
- Keep anti-coagulant antidote ready (protamine sulphate ect)
- Monitor vital signs

7. Nursing care plan for discharge medications, follow up & Health teachings
- Explain the name, purpose & side effect of each medicine
- Ask for regular follow up & continuing medications at home
- Teach about management of chest pain at home
- Teach how to take Nitroglycerine
- Explain diet to avoid large meals, rest after meals
- Ask to seak immediate medical aid if chest pain not relieved after taking GTN and rest.

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