Here we will formulate sample Myocardial Infarction (MI/ Heart Attack) nursing care plans based on a hypothetical case scenario.
It will include three Myocardial Infarction nursing care plans with NANDA nursing diagnoses, nursing assessment, expected outcome, and nursing interventions with rationales.
A 56-year old male presents to the ED with complaints of chest pain, shortness of breath, and nausea. The patient was watching TV when he started to experience what he thought was indigestion. The patient took an antacid but the pain quickly increased in intensity to 9/10 crushing chest pain.
When he started to feel nauseous and short of breath, he called an ambulance. The patient has a past medical history of hypertension, hyperlipidemia, and type 2 diabetes.
Upon assessment, the patient is diaphoretic and is visibly in pain. His temperature is 37.6 ˚C, heart rate is 95 beats per minute, blood pressure is 89/62 mmHg, respirations are 26 breaths per minute, and oxygen saturation is 96% on room air.
He is alert and oriented, his pulses are weak but palpable, and his capillary refill is greater than 3 seconds. The patient’s lung sounds are clear and a slight S3 murmur is heard when auscultating his heart.
Blood analysis reveals troponin of 35.2 ng/ml and CK-MB of 195 ng/mL. A stat 12-lead ECG is performed showing ST-elevation in leads II, III, and aVF and ST-depression in leads I, aVL, and aVR. A code STEMI is called.
The patient is admitted for an ST-Elevation Myocardial Infarction.
Subjective Data:
Objective Data:
Decreased cardiac output related to inadequate blood supply as evidenced by chest pain, hypotension, elevated cardiac enzymes, and ST-elevation.
Short-term goal: By the end of the shift the patient will be pain-free and the cardiac enzymes will begin to trend downward.
Long-term goal: The patient will maintain a normal ejection fraction with no long-term myocardial tissue damage.