Myocardial Infarction By Rnpedia

The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart. Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI. Edema is a later sign of heart failure, often seen after an MI. Palpitations may result from reduced cardiac output, producing arrhythmias.

These are likely signs of an acute myocardial infarction (MI). An acute MI is a cardiovascular emergency requiring immediate attention. Acute MI is potentially fatal if not treated immediately.

Exercise is important for all hospitalized patients to prevent deep vein thrombosis. Muscular contraction promotes venous return and prevents hemostasis in the lower extremities. This exercise is not sufficiently vigorous to increase physical fitness, nor is it intended to prevent bedsores or constipation.

This is a typical early finding after a myocardial infarct because of the altered contractility of the heart. The other choices are not typical of MI.

A history of cerebral hemorrhage is a contraindication to tPA because it may increase the risk of bleeding. TPA acts by dissolving the clot blocking the coronary artery and works best when administered within 6 hours of onset of symptoms. Prior MI is not a contraindication to tPA. Patients receiving tPA should be observed for changes in blood pressure, as tPA may cause hypotension.

Administering stool softeners every day will prevent straining on defecation which causes the Valsalva maneuver. If constipation occurs then laxatives would be necessary to prevent straining. If straining on defecation produced the valsalva maneuver and rhythm disturbances resulted then antidysrhythmics would be appropriate.

Establishing and maintaining a routine is essential to decreasing extraneous stimuli. The client should participate in daily care as much as possible. Attempting to reason with such clients isn’t successful, because they can’t participate in abstract thinking.

Pain associated with angina is relieved by rest. Answer B is incorrect because it is not a true statement. Answer Pain associated with angina is confined to the chest area is incorrect because pain associated with angina can be referred to the jaw, the left arm, and the back. Pain associated with myocardial infarction is referred to the left arm is incorrect because pain from a myocardial infarction can be referred to areas other than the left arm.

Nausea is a symptom of impending myocardial infarction (MI) and should be assessed immediately so that treatment can be instituted and further damage to the heart is avoided.

By the 2nd day of hospitalization after suffering a Myocardial Infarction, Clients are able to perform care without chest pain

Toxic levels of Lanoxin stimulate the medullary chemoreceptor trigger zone, resulting in nausea and subsequent anorexia.

This client is the most stable with minimal risk of complications or instability. The nurse can utilize basic nursing skills to care for this client.

Barbiturates are CNS depressants; the nurse would be especially alert for the possibility of respiratory failure. Respiratory failure is the most likely cause of death from barbiturate over dose.

Holding one's breath during activity can lead to the Valsalva maneuver, which is characterized by increased intrathoracic pressure. This can have negative effects on the cardiovascular system, including cardiac dysrhythmias and increased venous pressure. Therefore, the client should avoid holding their breath during activity to prevent the Valsalva maneuver.

Although the timing of initial elevation, peak elevation, and duration of elevation vary with sources, current literature favors option letter c.

High pulmonary artery wedge pressures are diagnostic for left-sided heart failure. With leftsided heart failure, pulmonary edema can develop causing pulmonary crackles. In leftsided heart failure, hypotension may result and urine output will decline. Dry mucous membranes aren’t directly associated with elevated pulmonary artery wedge pressures.

In a hospitalized patient on prolonged bed rest, he most likely cause of sudden onset shortness of breath and chest pain is pulmonary embolism. Pregnancy and prolonged inactivity both increase the risk of clot formation in the deep veins of the legs. These clots can then break loose and travel to the lungs. Myocardial infarction and atherosclerosis are unlikely in a 27-year-old woman, as is congestive heart failure due to fluid overload. There is no reason to suspect an anxiety disorder in this patient. Though anxiety is a possible cause of her symptoms, the seriousness of pulmonary embolism demands that it be considered first.

Morphine is administered because it decreases myocardial oxygen demand. Morphine will also decrease pain and anxiety while causing sedation, but isn't primarily given for those reasons.

The nurse should first ask the client if he has any concerns about his care. This is important because it allows the nurse to address any specific questions or worries that the client may have. It also demonstrates a patient-centered approach, showing that the nurse values the client's input and wants to ensure their satisfaction and understanding of their care. Allowing the client to view his chart or contacting the supervisor and physician for approval may be appropriate actions later on, but they are not the first step in this situation. Telling the client that he isn't permitted to view his chart would not be a respectful or patient-centered approach.

The sixty minute interval is known as “door to balloon time” for performance of PTCA on a diagnosed MI patient.

Canned fish and vegetables and cured meats are high in sodium. This meal does not contain any canned fish and/or vegetables or cured meats

Fever causes an increase in the body’s metabolism, which results in an increase in oxygen consumption and demand. This need for oxygen increases the heart rate, which is reflected in the increased pulse rate. Increased BP, chest pain and shortness of breath are not typically noted in fever.

The client with chest pain should be seen first because this could indicate a myocardial infarction. The client in answer A has a blood glucose within normal limits. The client in answer B is maintained on blood pressure medication. The client in answer D is in no distress.

In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn’t cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn’t one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough.

Morphine is a central nervous system depressant used to relieve the pain associated with myocardial infarction, it also decreases apprehension and prevents cardiogenic shock.

Patients with pulmonary edema experience air hunger, anxiety, and agitation. Respiration is fast and shallow and heart rate increases. Stridor is noisy breathing caused by laryngeal swelling or spasm and is not associated with pulmonary edema.

"When you can climb 2 flights of stairs without problems, it is generally safe." There is a risk of cardiac rupture at the point of the myocardial infarction for about 6 weeks. Scar tissue should form about that time. Waiting until the client can tolerate climbing stairs is the usual advice given by health care providers.

This provides the opportunity for the client to verbalize feelings underlying behavior and helpful in relieving anxiety. Anxiety can be a stressor which can activate the sympathoadrenal response causing the release of catecholamines that can increase cardiac contractility and workload that can further increase myocardial oxygen demand.

Administration of Intravenous Nitroglycerin infusion requires pump for accurate control of medication.

Having established, by stimulating the client, that the client is unconscious rather than sleep, the nurse should immediately call for help. This may be done by dialing the operator from the client’s phone and giving the hospital code for cardiac arrest and the client’s room number to the operator, of if the phone is not available, by pulling the emergency call button. Noting the time is important baseline information for cardiac arrest procedure.

Cardiogenic shock severely impairs the pumping function of the heart muscle, causing diminished blood flow to the organs of the body. This results in diminished brain function and confusion, as well as hypotension, tachycardia, and weak pulse. Cardiogenic shock is a serious complication of myocardial infarction with a high mortality rate.

The 83-year-old patient has no complicating factors at the moment. Providing care for stable and uncomplicated patients is within the LPN’s educational preparation and scope of practice, with the care always being provided under the supervision and direction of the RN. The RN should assess the newly post-operative patient and the new admission. The patient who is preparing for discharge after MI may need some complex teaching. Focus: Delegation/supervision, assignment

Temperature may increase within the first 24 hours and persist as long as a week.

Uncorrected atrial fibrillation can lead to the formation of blood clots (thrombus) in the atria of the heart. These blood clots can then travel to other parts of the body, causing blockages in the blood vessels. This can lead to serious complications such as stroke or pulmonary embolism. Therefore, the greatest danger of uncorrected atrial fibrillation for a male patient is thrombus formation.

An automatic internal cardioverter-defibrillator delivers an electric shock to the heart to terminate episodes of ventricular tachycardia and ventricular fibrillation. This is necessary in a patient with significant ventricular symptoms, such as tachycardia resulting in syncope. A patient with myocardial infarction that resolved with no permanent cardiac damage would not be a candidate. A patient recovering well from coronary bypass would not need the device. Atrial tachycardia is less serious and is treated conservatively with medication and cardioversion as a last resort.