7 Myocardial Infarction (Heart Attack) Nursing Care Plans

Monitor and document characteristic of pain, noting verbal reports, nonverbal cues (moaning, crying, grimacing, restlessness, diaphoresis, clutching of chest) andBP or heart rate changes. Variation of appearance and behavior of patients in pain may present a challenge in assessment. Most patients with an acute MI appear ill, distracted, and focused on pain. Verbal history and deeper investigation of precipitating factors should be postponed until pain is relieved. Respirations may be increased as a result of pain and associated anxiety; release of stress-induced catecholamines increases heart rate and BP. Obtain full description of pain from patient including location, intensity (using scale of 010), duration, characteristics (dull,crushing, described as like an elephant in my chest), and radiation. Assist patient to quantify pain by comparing it to other experiences. Pain is a subjective experience and must be described by patient. Provides baseline for comparison to aid in determining effectiveness of therapy, resolution and progression of problem. Review history of previous angina, anginal equivalent, or MI pain. Discuss family history if pertinent. Delay in reporting pain hinders pain relief and may require increased dosage of medication to achieve relief. In addition, severe pain may induce shock by stimulating the sympathetic nervous system, thereby creating further damage and interfering with diagnostics and relief of pain. Instruct patient to report pain immediately. Provide quiet environment, calm activities, and comfort measures. Approach patient calmly and confidently. Decreases external stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current situation. Instruct patient to do relaxation techniques: deep and slow breathing, distraction behaviors, visualization, guided imagery. Assist as needed. Helpful in decreasing perception and response to pain. Provides a sense of having some control over the situation, increase in positive attitude. Check vital signs before and after narcotic medication. Hypotension and respiratory depression can occur as a result of narcotic administration. These problems may increase myocardial damage in presence of ventricular insufficiency. Administer supplemental oxygen by means of nasal cannula or face mask, as indicated. Increases amount of oxygen available for myocardial uptake and thereby may relieve discomfort associated with tissue ischemia. Administer medications as indicated:

Link:
7 Myocardial Infarction (Heart Attack) Nursing Care Plans