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Myocardial Infarction

You are the nurse caring for a 48-year Leslie Collins, retired army officer for the United States military, He arrives to the emergency department after experiencing chest pain and shortness of breath. His EKG indicated he had a myocardial infarction (MI). He has a history of hypertension and high cholesterol. He states he used to smoke about 15 years ago, he has no other reported risk factors.

Based on this information, your prior knowledge of this client (refer to medical card from the Collins-Kim family tree interactive), and your knowledge of the pathophysiology of myocardial infarction (MI), respond to the following prompts:

  1. Thoroughly explain the pathophysiology of myocardial infarction (MI). Use a scholarly or authoritative source to support your answer.
  2. Examine each of the following three factors related to this disease process. Support all three with a scholarly source. cultural financial environmental implications
  3. Identify 3-5 priority nursing interventions for the client while in the emergency department.
  4. Describe labs and diagnostic testing you would want to include in client’s plan of care and why. What are critical indicators? Support with a scholarly source.
  5. What members of the interdisciplinary team need to be included for holistic patient-centered care?
Full Answer Section

Specifically, I would:

  • Monitor the patient's vital signs and ECG closely. I would check the patient's blood pressure, heart rate, respiratory rate, and temperature every 15-30 minutes, or more often if needed. I would also monitor the patient's ECG for any signs of arrhythmias.
  • Administer oxygen and pain medication as needed. I would administer oxygen to the patient to maintain his oxygen saturation above 90%. I would also administer pain medication, such as morphine, to control the patient's chest pain.
  • Establish IV access to administer medications and fluids. I would establish IV access to administer medications and fluids as needed. I would also administer fluids to maintain the patient's hydration status and prevent hypotension.
  • Monitor the patient's cardiac output and tissue perfusion. I would monitor the patient's cardiac output by assessing his urine output and skin perfusion. I would also monitor the patient's tissue perfusion by assessing his capillary refill time and skin temperature.
  • Assess the patient's risk for complications. I would assess the patient's risk for complications, such as heart failure, arrhythmias, and pulmonary embolism. I would also assess the patient's risk for other complications, such as pneumonia and deep vein thrombosis.
  • Educate the patient about his condition and lifestyle modifications to reduce his risk of future cardiovascular events. I would educate the patient about his condition, including the causes, symptoms, and treatment of MI. I would also educate the patient about lifestyle modifications to reduce his risk of future cardiovascular events, such as quitting smoking, eating a healthy diet, exercising regularly, and controlling his blood pressure and cholesterol levels.

In addition to the above, I would also provide the patient with emotional support and comfort. I would also keep the patient's family informed of his condition and prognosis.

Sample Answer

As the nurse caring for a 48-year-old male patient with a myocardial infarction (MI), hypertension, and high cholesterol, my primary goals are to:

  • Monitor the patient's vital signs and ECG closely to assess for any signs of cardiac distress.
  • Administer oxygen and pain medication as needed.
  • Establish intravenous (IV) access to administer medications and fluids.
  • Monitor the patient's cardiac output and tissue perfusion.
  • Assess the patient's risk for complications, such as heart failure, arrhythmias, and pulmonary embolism.
  • Educate the patient about his condition and lifestyle modifications to reduce his risk of future cardiovascular events.

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