Myocardial Infarction

MYOCARDIAL INFARCTION

Myocardial infarction (MI) is caused by marked reduction/loss of blood flow through one or more of the coronary arteries, resulting in cardiac muscle ischemia and necrosis.

CARE SETTING

Inpatient acute hospital, step-down, or medical unit.

RELATED CONCERNS

Angina

Dysrhythmias

Heart failure: chronic

Psychosocial aspects of care

Thrombophlebitis: deep vein thrombosis

Patient Assessment Database

ACTIVITY/REST

May report: Weakness, fatigue, loss of sleep

Sedentary lifestyle, sporadic exercise schedule

May exhibit: Tachycardia, dyspnea with rest/activity

CIRCULATION

May report: History of previous MI, CAD, HF, hypertension, diabetes mellitus

May exhibit: BP may be normal, increased, or decreased; postural changes may be noted from lying to sitting/standing

Pulse may be normal, full/bounding, or have a weak/thready quality with delayed capillary refill; irregularities (dysrhythmias) may be present

Heart sounds S3/S4 may reflect a pathological condition (e.g., cardiac failure, decreased ventricular contractility or compliance)

Murmurs may reflect valvular insufficiency or papillary muscle dysfunction

Friction rub (suggests pericarditis)

Heart rate regular or irregular; tachycardia/bradycardia may be present

Edema: Jugular vein distention, peripheral/dependent edema, generalized edema

Color: Pallor or cyanosis/mottling of skin, nailbeds, mucous membranes, and lips may be noted

EGO INTEGRITY

May report: Denial of significance of symptoms/presence of condition

Fear of dying, feelings of impending doom

Anger at inconvenience of illness/”unnecessary” hospitalization

Worry about family, job, finances

May exhibit: Denial, withdrawal, anxiety, lack of eye contact

Irritability, anger, combative behavior

Focus on self/pain

ELIMINATION

May exhibit: Normal or decreased bowel sounds

FOOD/FLUID

May report: Nausea, loss of appetite, belching, indigestion/heartburn

May exhibit: Poor skin turgor;...