3 dx care plan -MI PDF

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Summary

3 diagnosis care plan for myocardial infarction ...

Description

Problem/Priority

1. Myocardial

S/O Data

Intervention(s)

Rationale

Subjective Data:Chest Pain, Chest Pressure/Squeezing Objective Data: ST elevation on the ECG- Called an STEMI

12-Lead ECGIf initial 12lead ECG indicates inferior MI, do a right-sided 12lead ECG.

Oxygen: check oxygenation for chest pain – if under 94% or if patient is short of breath give 2L NC initially. Nitroglycerin: This is the initial medication given, along with aspirin. This medication dilates the blood vessels to help allow any blood flow that might be impeded. Give 0.4 mg sublingual tab, wait 5 minutes, if the chest pain is not relieved administer another dose. This can happen 3 times total. Aspirin: given to thin the blood and decrease mortality risk. Morphine: given ONLY if aspirin and nitroglycerin do not relieve chest pain. Initial dose is 2-4 mg IV.

Infarction (MI) https://nursing.com/lesson/ nursing-care-plan-formyocardial-infarction-mi/

Nitroglycerin Aspirin

Nursing Dx: Ineffective cardiac tissue perfusion related to reduced coronary blood flow.

Give Oxygen Morphine

Cardiac Catheterization with Percutaneous Coronary Intervention BP Monitoring 2. Grieving/loss after an MI Nursing Dx: Anticipatory grieving

Subjective Data: The patient's wife stated “my husband is sad that he can no longer enjoy the same foods and lifestyle. He said he doesn’t want to look forward to the future”. Patient expressed guilt, remorse, and fear about the changes that will occur because of his diagnosis.

Assess the phase of grieving being experienced by the patient and/or the significant other (wife).

Communicate therapeutically with patient & wife to allow them to verbalize feelings

Expected Outcome Re-perfusion to cardiac muscle and return of cardiac muscle functionality, or as much as possible.

Monitor a patient’s blood pressure, hold for a systolic BP of less than 90 mmHg. This is important because the higher the blood pressure, the more pressure is on a clot. I The patient may need several months to adapt to the loss and go back to normal daily functioning. Patients and family can revisit the phases of the grief repeatedly. Sharing feelings with the healthcare provider may help the patient find significance in the loss. Support in the grieving process

Patient and or his wife verbalizes feelings and establishes and maintains functional support systems. https://nurseslabs.com/grievin g/

3. Discharge Planning Nursing Dx: Interrupted family process

Objective Data:

Refer the patient and family to community resources

comes in many forms. Having the same experience from a community group is helpful in allowing the family to continue on with life.

Subjective: The pt stated that he and his wife just don’t have much time for cooking, We probably eat out 4 times a week. Diets never work for me.”

Refer the pt to support groups and other resources that will help the pt and family adjust to new lifestyle measures

Altered family process as a result of one or more members of the family having the inability to adjust or perform the normal tasks or routines, as well as dietary norms, resulting in disruption and interruption or prevention of development in the family.

Pt stated “I did stop smoking about a month age, it was hard. I considered chewing tobacco or trying e-cigarettes to make it easier. But I changed my mind Pt stated “I walk at work, I don’t have time to go to the gym during the week. My wife and I usually go for a walk” Objective Data: Elevated BP (HTN) BMI...