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Nursingcrib.com Nursing Care Plan - Myocardial Infarction

Nursingcrib.com Nursing Care Plan - Myocardial Infarction

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Published by deric
an individualized care plan for patients with myocardial infarction
an individualized care plan for patients with myocardial infarction

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Published by: deric on Apr 25, 2009
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05/11/2014

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NURSING CARE PLAN  – Myocardial InfarctionASSESSMENTDIAGNOSISINFERENCEPLANNINGINTERVENTIONRATIONALEEVALUATION
SUBJECTIVE:“Sumasakit angdibdib ko”
(
I’vebeen experiencing chest pains
)
asverbalized by thepatientOBJECTIVE:
Restlessness
Facialgrimace
Pain scale of 9 out of 10
V/S taken asfollowsT: 37.6 ˚CP: 112R: 12BP: 140/ 100Pain r/t tissueischemia(coronaryarteryocclusion
)
Occlusion of coronary arteryDecrease bloodflow to themyocardiumDecreaseoxygen supply(ischemia)AnaerobicmetabolismLactic acidformationpainAfter 8 hours of nursingintervention thepatient willVerbalizerelief/control of chest pain withinappropriate timeframe for administeredmedications
.
Independent:
Obtain fulldescription of painfrom patientincluding location,intensity (0–10),duration,characteristics(dull/crushing), andradiation. Assistpatient to quantifypain by comparing itto other experiences
Instruct patient toreport painimmediately.
Provide quietenvironment, calmactivities, andcomfort measures
Assist/instruct inrelaxationtechniques, e.g.,deep/slowbreathing,distraction
Pain is a subjectiveexperience and mustbe described bypatient
Delay in reportingpain hinders painrelief/may requireincreased dosage of medication toachieve relief 
Decreases externalstimuli, which mayaggravate anxietyand cardiac strain,limit coping abilitiesand adjustment tocurrent situation
Helpful in decreasingperception of/response to pain.Provides a sense of having some controlover the situation,Goal met, patienthasverbalizedrelief/control of chest pain withinappropriate timeframe for administeredmedications.
 
 Student Nurses’ Community
behaviors,visualization, guidedimagery
Collaborative
Administer supplementaloxygen by means of nasal cannula or face mask, asindicatedAdminister medicationsas indicated:
Antianginals, e.g.,nitroglycerin,isosorbide dinitrate(Isordil)
Beta-blockers, e.g.,atenolol (Tenormin),propranolol(Inderal), metoprolol(Lopressor)
Analgesics, e.g.,morphine,meperidine(Demerol)increase in positiveattitude.
Increases amount of oxygen available for myocardial uptakeand thereby mayrelieve discomfortassociated withtissue ischemia
Nitrates are useful for pain control bycoronary vasodilatingeffects, whichincrease coronaryblood flow andmyocardial perfusion.
Important second-lineagents for paincontrol through effectof blockingsympatheticstimulation, therebyreducing heart rate,systolic BP, andmyocardial oxygendemand
Although intravenous(IV) morphine is theusual drug of choice,other injectablenarcotics may beused in
 
acute-

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