Introduction/Etiology and Pathophysiology of STEMI
Myocardial infarction is a serious and potentially life threatening emergency. Rapid assessment and diagnosis is imperative to correctly treat a patient. It is essential for the nurse and healthcare team to understand the diagnostic procedures, lab tests, and treatments that can provide life -saving treatment for a patient presenting with chest pain. Myocardial infarctions can occur in different parts of the heart and can be given different classifications depending on the presenting symptoms. The most serious type of myocardial infarction is classified as an ST-elevation myocardial infarction or STEMI.
A STEMI is one type of heart attack that involves an ST-elevation myocardial infarction (CDC, 2010). A STEMI is the traditional manifestation and was historically used to diagnose a myocardial infarction (Ignatavicius & Workman, 2013, p. 829). It is now known that not all patients experiencing a myocardial infarction will present this way (Ignatavicius & Workman, 2013, p. 829). According to Ignatavicius and Workman (2013), patients presenting with STEMI typically have ST elevation in two contiguous leads on a 12-lead ECG. A STEMI indicates myocardial infarction or necrosis and requires immediate treatment (Ignatavicius & Workman, 2013, p. 829). According to the American Heart Association (AHA) (2010), STEMI comprises 25% to 40% of the 683,000 United States patients diagnosed with acute coronary syndrome each year.
A myocardial infarction occurs when the myocardial tissue is abruptly and severely deprived of oxygen (Ignatavicius & Workman, 2013, p. 829). Due to this quick decrease in blood flow, ischemia develops which can then lead to injury and necrosis of the myocardia...
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...hey may need to have surgical management, which could require another PTCA or CABG. In the case of surgery, the nurse would need to monitor her patient for post-operative complications.
Conclusion
In conclusion, coronary health is of utmost importance. The prevalence of coronary heart disease and acute coronary syndromes is alarming. Education and changing modifiable risk factors are essential to promote cardiac health, and decreasing the chance of an MI. An acute myocardial event such as a STEMI can be an acutely life threatening. Rapid diagnosis and treatment is imperative to provide the best chance of reperfusion to the myocardial muscle to restore oxygen and blood flow to decrease injury and complications. It is essential that the nurse be educated on the signs, symptoms, diagnosis, and treatment of a STEMI to help achieve the best outcome for the patient.
Retrieved on March 2014 from world wide web at http://www.webmd.com/heart-disease/guide/heart-disease-heart-attacks Wolf, Zane Robinson & Hughes, Ronda G (n.d.). Error Reporting and Disclosure. Retrieved on March 2014 from world wide web at http://www.ncbi.nlm.nih.gov/books/NBK2652
This also caused an increase in demand of oxygen to the cardiac muscle so it’s not a good thing (Ignatavicius &Workman, 2013, p. 747).
The patient is a 45 year old male who was in a car accident that
After review of the clinical information provided by North Central Bronx Hospital, the Medical Director has denied your admission to North Central Bronx Hospital. It was determined that the clinical information did not justify an inpatient stay. Acute inpatient hospitalization was not medically necessary. You are a 56 year old female with complaints of worsening pressure-like chest pain on the left sided that radiated to your left arm and neck. The symptoms began when you were at rest and woke you from your sleep. Based on the Interqual guideline (a decision based program to determine medical need) criteria to for acute coronary syndrome the clinical guidelines were not met because troponins were negative, there was no diagnostic testing such as a stress test, or documentation of ischemia in the clinical information that was submitted.
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
The preliminary step in myocardial infarction is atherosclerosis. Atherosclerosis does not occur abruptly, it is a gradual and dynamic inflammatory disease which causes the narrowing of lumen due to the deposition of lipid and foam cells. The formation of fatty streak; which will eventually become a plaque causes the vessel lumen to diminish. The plaque will become unstable, rupture and eventually lead to the event of plaque disruption.
According to the Registered Nurse (RN) Scope of Practice Position Statement, “the RN is responsible for providing safe, compassionate, and comprehensive nursing care to patients and their families with complex healthcare needs” (Texas Board of Nursing, 2011). Nurses often care for five to six patients at one time; therefore, in order to provide the best quality care, patients are often connected to monitoring devices such as, physiological monitors, venti...
This assignment is a case study that aims to explore the biospychosocial impacts of a myocardial infarction on a service user. It will focus on the interventions used by healthcare professionals throughout the patient’s journey to recovery. To abide by the NMC’s code of conduct (2015) which states that all nurses owe a duty of confidentiality to all those who are receiving care, the service user used in this case study will be referred to as Julie. Julie is a 67 year old lady who was rushed to her local accident and emergency following an episode of acute chest pain and was suspected to have suffered from a myocardial infarction. Julie who lives alone reported she had been experiencing shortness of breath and
759. Mr. Miller is likely presenting with an acute myocardial infarction. Based on his past medical history of hypertension, hyperlipidemia, obesity, and diabetes, along with his current symptoms of chest pain, shortness of breath, pale skin with beads of sweat on the forehead, as well as elevated lab 's Troponin, CK, and CK-MB, he is most likely presenting with an acute myocardial infarction.
One of the leading causes of death in the United States is heart disease. “Approximately every 29 seconds one American will have a heart attack, and once a minute one American will die from a heart attack” (Ford-Martin and Odle, 915). According to the Gale Encyclopedia of Alternative Medicine men over the age of 45 and women over the age of 55 are considered at risk for heart disease. Heart disease is a major cause of death. It is beneficial to individuals who seek to prevent heart disease to recognize the risks leading to heart attacks as they are one of the primary indications of developing heart disease; especially those that fall into the at risk age groups. These risks consist of some that cannot be changed such as heredity risks, or those that can change such as smoking habits. It is very important to know these specific risks for prevention and to understand the symptoms of heart attacks, such as sweating or the feeling of weakness so if these or other symptoms occur people are aware. Finally heart disease treatment is of vital importance if you experience a heart attack so you can learn how to prevent another one from occurring.
Oxygen is widely used in both chronic and acute cases, in emergency medicine, at hospital or by emergency medical services (Nicholson, 2004 ). Just like any other form of medication oxygen is a drug that if used incorrectly could cause potential harm, even death (Luettel, 2010 ). Oxygen is admitted to the patient with chest pain for two main rationales. The first is by increasing arterial oxygen tension, which in opposing causes a decrease to the acute ischemic injury, and thus over time the entire infarct area (Moradk...
middle of paper ... ... The priority for this patient was to establish that she was fully aware of what the procedure involved and the possible risks and complications. I feel that the pre-assessment form used within the unit is far too fundamental, if elements of the roper et al activities of daily living were to be incorporated this would help in achieving a much more in-depth holistic nursing assessment enabling for the best quality and level of care to be given to all patients arriving in the unit. Whilst I feel a full nursing assessment is not fully necessary for a day case unit, as previously stated I feel that the communication element is an excellent way of ensuring a better holistic approach is achieved, it will also help to achieve better documentation and communication between all staff members.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
According to the American Heart Association (American Heart Association, n.d.) approximately 850 Americans die every day from sudden cardiac arrest. Of these, eighty percent of them occur in the ...