Myocardial Infarction - Research Paper Example

Myocardial Infarction Introduction. Myocardial infarctions or acute myocardial infarction (MI) is commonly called heart attack and is a serious disease of coronary which occurs due hardening or narrowing of arteries when cholesterol plaque builds up. Blockage of arteries leads to a major reduction of blood supply, consequently causing necrosis (death or damage) of heart muscles (myocardium) or myocardium ischemia as the heart muscles are not served with oxygenated blood for quite some time (Life nurses forum:Nursing care plans for Myocardial infarction (MI)) (Imagins website:The women health resource,Overview of myocardial infarction.). The infarction site depends on which vessels are involved. For example, if blockage occurs in circumflex coronary artery, this leads to lateral MI while blockage of right coronary artery can lead to right sided heart failures (Life nurses forum: Nursing care plans For Myocardial infarction). There are many predisposing factors to the higher number of MI cases. Some of these factors can be controlled while others cannot. These factors are; age, gender, positive family history of MI, high blood pressure, obesity, high levels of cholesterol, lack of physical activity, diabetes, stress, hypertension, increased serum triglycerides, excessive intake of saturated fats, salt and carbohydrates (Salim). Other risk factors includes, sedentary life, increased homocysteine and C -resistance proteins and use of drugs such as amphetamines and cocaine (Life nurses forum: Nursing care plans for myocardial infarction; (Haffner).About 20% of patients with MI have diabetes (Salim). The symptoms of MI includes; arm, epigastric and chest pain, breath shortness, diaphoresis, clammy skin dizziness, nausea, vomiting, angina frequency, fatigue, presence of pericardial friction rub, systolic murmurs, bradycardia, hypertension, absence of jagular vein distension, activity intolerance, decreased cardiac output, anxiety, among other symptoms (Life nurses forum: Nursing care plans for Myocardial infarction). Nursing process in Myocardial infarction. Nursing process is a very important thinking tool and involves a number of stages. Assessment This stage involves collecting and recording of data so as to obtain the necessary information which will help a nurse or a clinician to predict, detect, prevent, manage and eliminate health problems and associated risk factors. During the assessment, the nurse should be able to clarify the expected outcomes and the advantages of the care. These outcomes should be measurable. The nurse should also be able to choose intervention strategies to be used in achieving the desired results and promoting patients health (Afaro) Diagnosis Diagnosis is very important as it helps in analyzing and synthesis of data so as to facilitate drawing of conclusions. Diagnosis can be achieved through physical examination of symptoms. Other diagnostic tests which can be used includes, detection of elevated levels of homocysteine and C- resistance proteins, electrocardiogram, use of cardiac troposin to differentiate between MI and injury of skeletal muscles. This can also be achieved through looking at the family history to identify if there is positive relationship. During diagnosis, the nurse should identify patterns and produce a list of suspected problems and also rule out the presence of other health issues. Identification of symptoms is important as this may help the nurse to refer the case to more qualified personnel if need be (Afaro). The nurse should be able to clarify actual and potential health issues and the associated risk factors. Reflective thinking is also an important component during diagnosis. The nurse should be able to find out if the participation of the patient is optimal, if the data is complete and accurate, if there are assumptions identified and finally if conclusions are drawn from the facts of evidence obtained because there are other possible conclusions which can be drawn from the data obtained (Life nurses forum: Nursing care plans for Myocardial infarction). Planning Planning ensures that each patient has individualized, complete and thorough plan containing the expected outcomes and the intervention strategies to be put in place. The plan should be able to detect, prevent and manage the heart problems and the associated risk factors (Afaro).The first priority should be made to address risk factors, promotion of health independence of the patient. The patient should also adviced so that he / she is engaged in decision making. This ensures that the anticipated results are achieved safely and expeditiously in a cost effective manner. All care communicated and patient progress should be recorded (Life nurses forum: Nursing care plans for Myocardial infarction; Afaro) Implementation / Intervention This process involves putting the plan into action. Most patients suffering from MI receive medical attentions in coronary care unit (CCU) which allows frequent observation of emerging complications. In implementing the plan, the nurse should ensure that the chosen interventions are the most appropriate and whether the patient is ready for them. The decision of the patient should be considered. The nurse should perform the intervention and assess the initial responses In case of non –anticipated results of the interventions, changes should be made in the plan. These interventions includes, assessing pain and giving analgesics, taking ECG reading, bloods pressure, detecting serum enzymes levels etc (Life nurses forum: Nursing care plans for Myocardial infarction ; Afaro) Monitoring and Evaluation This step is important as it involves assessing of patients status to find out if the desired results have been achieved. It also involves determining which factors produced positive impacts or inhibited success of the plan. Evaluation should also involve risk assessment to determine future events such as re-infarction so as to put in place measures to prevent them (Frans Ven de Weif.).This step should continue even after the patient is discharged. Rehabilitation and pre-discharge advice This step should be done during patient admission, before discharge and after. It is a very significant step as it helps the patient to attain full independence of life. Advice should be provided on psychological and socio-economic aspects, life style changes on dietary, diet changes, on physical activity and on control of weight (Frans Ven de Weif.). References: 1. Afaro, K. Handouts. Afroteach smart.com The nursing process.A critical thinking tool. 2004. 30 Oct. 2011 . 2. Frans Ven de Weif., Jeroen,B., Amadeo,B., Carina,B.L., Filippo,C., Volkmar, F., Gerasimos,F.., Keith,F., Kurt,H., Adam,K., Annika,R.,Gabriel.S.P., Mario,T., Freek,V., Franz,W and Michael,W. "Management of acute myocardial infarction in patients presenting with persistent ST- segment elevelation." European heart journal 29 (2008). 3. Haffner, S.M., Seppo,L., Tapani,R., Kalevi,P and Markku,L.,. "Mortality from coronary heart diseasesin subjects with type 2 diabetes and in non-diabetic subjects with and without myocardial infarction." The new England journal of medicine 339.4 (1998): 229-234. 4. Imagins website:The women health resource,Overview of myocardial infarction. 1997. 30 Oct. 2011 . 5. Life nurses forum:Nursing care plans for Myocardial infarction (MI). 22 Dec. 2009. 30 Oct. 2011 6. Salim, Y., Steven,H., Stephania,O., Tony,D., Alvaro,A., Fernando,L., Mathew,M., Andrzej,B., Prem,P., John,V and Liu,L. "Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study ) Case- control study." (2004). Read More