Nanda Books

Myocardial infarction (MI) or acute myocardial infarction (AMI) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Myocardial infarction most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids (cholesterol and fatty acids) and white blood cells (especially macrophages) in the wall of an artery. The resulting ischemia (restriction in blood supply) and ensuing oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death (infarction) of heart muscle tissue (myocardium).

Chest pain or pressure is the most common symptom of a heart attack, Myocardial infarction (MI) or heart attack victims may experience a variety of symptoms including:

• Pain, fullness, and/or squeezing sensation of the chest
• Jaw pain, toothache, headache
• Shortness of breath
• Nausea, vomiting, and/or general epigastric (upper middle abdomen) discomfort
• Sweating
• Heartburn and/or indigestion
• Arm pain (more commonly the left arm, but may be either arm)
• Upper back pain
• General malaise (vague feeling of illness)
• No symptoms (Approximately one quarter of all heart attacks are silent, without chest pain or new symptoms. Silent heart attacks are especially common among patients with diabetes mellitus.)

An MI requires immediate medical attention. Treatment attempts to salvage as much myocardium as possible and to prevent further complications, hence the phrase "time is muscle". Oxygen, aspirin, and nitroglycerin may be administered. Morphine was classically used if nitroglycerin was not effective; however, it may increase mortality in the setting of NSTEMI. A 2009 and 2010 review of high flow oxygen in myocardial infarction found increased mortality and infarct size, calling into question the recommendation about its routine use. Other analgesics such as nitrous oxide are of unknown benefit. Percutaneous coronary intervention (PCI) or fibrinolysis are recommended in those with an STEMI. (wikipedia)


Nursing Care Plan for Myocardial Infarction

12 Nursing Diagnosis for Myocardial Infarction

1. Decreased Cardiac Output
related to:
changes in the frequency of heart rhythm.

2. Impaired Tissue Perfusion
related to:
decrease in cardiac output.

3. Ineffective Airway Clearance
related to:
accumulation of secretions.

4. Ineffective Breathing Pattern
related to:
lung development is not optimal.

5. Impaired Gas Exchange
related to:
pulmonary edema.

6. Acute Pain
relate to:
increase in lactic acid.

7. Fluid Volume Excess
related to:
retention of sodium and water.

8. Imbalanced Nutrition, Less Than Body Requirements
related to:
Inadequate intake.

9. Activity Intolerance
relate to:
imbalance between myocardial oxygen supply and needs.

10. Self-Care Deficit
related to:
physical weakness.

11. Anxiety
related to:
ncaman death.

12. Knowledge Deficit
related to:
lack of information.