Case Study For Myocardial Infarction Assignment
Case Study For Myocardial Infarction Assignment
Case Study Rubric (Student must receive disease/ disorder approval from faculty PRIOR to beginning work)
Required Elements
Points Distribution
Case Study
Choose a disorder or disease from the content covered in Medical-Surgical I
Discuss the incidence – why does it occur
Discuss the pathophysiology – how does it occur
Why is this disorder or disease important for you and your classmates to know
What are the sign and symptoms that occur with this disease or disorder? Case Study For Myocardial Infarction Assignment
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Are there warning signs? What are they?
What are the diagnostic tests that are normally associated with this disease or disorder?
What are the current treatments?
What is the prognosis?
What are emotional issues that may affect the family AND patient regarding the diagnosis of this disease or disorder?
All elements required are present
Missing one of the required elements
Missing two – four of the required elements OR the required elements are poorly constructed
Missing five or more of the required elements OR the required elements are poorly constructed Case Study For Myocardial Infarction Assignment
46-60
31-45
16-30
1-15
Care plan
NANDA 3 priority nursing diagnoses
NANDA 3 priority nursing interventions for each nursing diagnosis
9-10
6-8
4-5
1-3
Teaching Plan
What community resources are available to assist the patient and family with this disease or disorder?
What are two important points that nurses should be aware of to provide culturally competent care to the family and patient with this disease or disorder?
9-10
6-8
4-5
1-3
Additional Criteria
Submitted on time
Presentation is professional and less than 10 minutes
APA 7th edition format is use correctly
Grammar and punctuation are correct
Myocardial Infarction
Incidence
Myocardial infarction (MI) also known as heart attack is a dangerous condition that occurs due to insufficient blood flow in the heart muscles. There are several factors that make the blood flow problematic but among them is when there is a blockage in the arteries. Lack of blood flow in the artery or several arteries causes the heart muscle to start dying (Saleh, 2018). Failure to restore the blood flow swiftly there is a high chance of heart attack that can result in permanent damage to the heart or even death. The disease is among the leading causes of mortality across the developed world. For instance, its prevalence in the United States is over one million deaths annually and affects about three million people globally. The incidence of myocardial infarction is highest among older persons compared to the young. For instance, though there is limited data regarding its incidences among the younger subjects it is estimated that males between 30 and 34 have an incidence rate of 12.9/1000 while females of the same age have an incidence rate of 5.2/1000. However, the myocardial infarction rate is said to be nine times higher in persons between 55 and 64 years (Mechanic, 2022)Case Study For Myocardial Infarction Assignment.
Pathophysiology
The onset and the occurrence of myocardial infarction are unpredictable. The blockage of one or more arteries in the heart for over 20 to 40 minutes leads to an acute heart attack (Saleh, 2018). The blockage occurs as a result of the thrombosis and also due to the tearing of the plaque that forms inside the coronary arteries. Such occlusions cause a deficiency of oxygen along the myocardium that causes myofibril relaxation and sarcolemma disruption. Such changes mark the beginning of the ultrastructural effects hence the development of myocardial infarction that are later preceded by mitochondrial alterations. The incidence of prolonged ischemia causes damage to the heart muscles and spread from the sub-endocardium to the sub-epicardium (Taggart, 2021)Case Study For Myocardial Infarction Assignment. The nature of the myocardial infarction depends on the territory affected.
Importance of myocardial infarction
The disease is important because it is a leading cause of death among men and women in the United States. The disease is important to me and my classmates because it is one of the least researched, least understood, and also not overly discussed. Also, it is important to learn about the disease because it is a major health concern across the country. Learning about it helps in identifying and also in managing the health risk factors and finding solutions including regular exercise, and healthy eating (Mechanic, 2022). In addition, knowledge of myocardial infarction helps in advising people at risk when to visit a doctor and the best ways to monitor weight, cholesterol levels, and blood pressure (Saleh, 2018)Case Study For Myocardial Infarction Assignment. It is also essential to know about the disease because it is mainly silent and goes undetected to many people until it is too late.
Signs and symptoms
Myocardial infarction presents with several symptoms with some being more common than others. The most common symptoms include chest pains that begin as mild where the affected person feels heaviness or discomfort. The severe chest pains are more severe and the affected individuals feel the crushing pains in the chest (Taggart, 2021). This pain may gradually start on the chest and spread to other parts of the body starting with the left arm, or both hands, shoulders, the neck, the jaws, the back side, and then down to the waist. An important symptom is when one develops trouble when breathing or has shortness of breath, fatigue, insomnia, and heart palpitations. In addition, one develops stomach discomfort or nausea and this may cause the myocardial infarction to be confused with heartburn or indigestion (Saleh, 2018)Case Study For Myocardial Infarction Assignment. Further, signs include feeling dizzy, lightheaded, and sweating and some develops anxiety.
Warning signs
The initial warning sign that one is suffering from myocardial infarction is the feeling of chest discomfort or pain. When there is discomfort at the left side or at the center of the chest that last for minutes and disappears and reappears once more then there is a likelihood of heart attack. This discomfort mainly feels like squeezing, uncomfortable pressure, pain, or fullness. Also, some other warning signs include feeling lightheaded, feeling weak, and sometimes fainting and one may develop some cold sweat (Saleh, 2018). Also, at some point, there is discomfort in the back, neck, or on jaw, and also where pain arises in the shoulders and arms. At some point, the affected person develops shortness of breath, unexplained tiredness, vomiting, or nausea. When any of these symptoms are noticed it is advisable to immediately call the help center for emergency services (Mechanic, 2022)Case Study For Myocardial Infarction Assignment. This is because the sooner one gets to the emergency room the higher the chances of recovery and reduction of further damage to the heart.
Diagnostic tests
When a patient is suspected to suffer from myocardial infarction several tests can be used to determine the underlying issue. The most important is the electrocardiogram (EKG or ECG). The test should be done immediately after one is admitted to a health center to measure the electrical activity of the heart. The ECG system records the heart signals on paper and allows the doctor to evaluate the heart’s performance. The test is painless and only takes about five minutes. A blood test is also crucial and is performed to examine the leakage of heart proteins into the blood system. The test helps the doctor in evaluating the presence of such proteins called cardiac markers. Chest X-ray is an important test that visually demonstrates the condition of the heart and its size. There is also the echocardiogram test that examines the sound waves of the heart and informs the doctor about the movement of blood around the heart valves (Saleh, 2018)Case Study For Myocardial Infarction Assignment. Coronary catheterization or the angiogram is a test involving a long tube inserted through the artery mostly in the leg and then guided through to the heart. There is a certain dye that flows through this tube and helps in demonstrating the wellness of the arteries. Further, a cardiac CT scan or an MRI can be used in testing the chest and heart condition (Taggart, 2021). The test can help in visually showing the severity of the cardiac damage and the exact part that is affected.
Current Treatments
Heart treatment is done immediately after diagnosis because any delay results in more damage to the heart tissues. Aspirin is an important medication when a heart attack is noticed because it helps reduce clotting and may be used for emergency cases (Taggart, 2021). Clot busters such as fibrinolytic or thrombolytics are also essential in breaking up the blood clots in the arteries. IV injections of heparin are also used in blood thinning and make it hard for blood to develop clots. Nitroglycerin is also an important medication that is used in widening the blood vessels hence reducing the blockages (Mechanic, 2022). Beta-blockers and ACE inhibitors are crucial medications used in slowing heartbeats and thus reducing blood pressure and helping limit damage to the heart. There are also surgical treatment methods used in managing myocardial infarction such as coronary stenting and angioplasty a procedure conducted to open the blocked arteries. There is also the coronary artery bypass procedure where a surgeon uses a new artery from another part of the body and makes a new bypass to the blood (Saleh, 2018)Case Study For Myocardial Infarction Assignment.
Prognosis
Despite the advanced modern-day treatment still, myocardial infarction has a mortality rate of between five and 30% and many deaths occur immediately after patients arrive in hospitals. Factors that worsen the disease include patients suffering from diabetes, advanced age, persons with congestive heart failure, and delayed reperfusion (Taggart, 2021). Also, persons suffering from depression are at a higher chance of developing the disease.
Emotional issues that may affect the family AND patient regarding the diagnosis
Diagnosis of myocardial infarction is a life-changing moment. When an individual is diagnosed with this disease there are high chances of developing stress and also the family is largely affected. This is because suffering from myocardial infarction makes many people believe that they are dying or may die anytime hence resulting to anxiety. Psychologically patients and their families are affected because of the changes that come to loved ones from this condition. This is because several things have to change including lifestyles and work, and to some, this might bring issues when it comes to life adjustment (Taggart, 2021)Case Study For Myocardial Infarction Assignment. Some soon develop mild depressive symptoms and other severe emotional distress as they try to think of such a dangerous condition.
Care Plan
The NANDA priority nursing diagnoses for myocardial infarction include problem-focused diagnoses, risk diagnoses, and health promotion diagnosis. The problem-focused diagnosis will include an evaluation of the observable patients’ issues including signs and symptoms. The priority nursing interventions for this type of diagnosis involve related factors, defining characteristics, and actual diagnosis. The risk diagnosis is done through clinical judgment regarding the vulnerability of the patient. This type of diagnosis for myocardial infarction is done through priority interventions such as risk factors, diagnostic labels, and observable patient issues. Further, the health promotion diagnosis for myocardial infarction’s main priority interventions includes those related to the community, family, and individuals (Shin, 2021)Case Study For Myocardial Infarction Assignment.
Teaching plan
There are several community resources available to assist the patient and family in dealing with myocardial infarction. They include the community health centers for cardiac rehabilitation, education programs, books and websites about cardiac management, and cardiac clinics in hospitals. There is also a community helpline with a fast dial number in case of emergency services, dietitians for both cardiac inpatients and outpatients, and stop-smoking programs.
Nurses should be aware of the diverse religions and ethnicities of patients and families in order to provide culturally competent care as a result of a diagnosis with myocardial infarction (Jongen, 2018)Case Study For Myocardial Infarction Assignment. This will help the nurse stop disregarding patients’ beliefs and will assist them to develop better communication and understanding of patients’ points of view and expressions.
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References
Jongen, C., McCalman, J., & Bainbridge, R. (2018). Health workforce cultural competency interventions: a systematic scoping review. BMC health services research, 18(1), 232. https://doi.org/10.1186/s12913-018-3001-5
Mechanic OJ, Gavin M, Grossman SA. (2022). Acute Myocardial Infarction. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459269/
Saleh, M., & Ambrose, J. A. (2018). Understanding myocardial infarction. F1000Research, 7, F1000 Faculty Rev-1378. https://doi.org/10.12688/f1000research.15096.1
Shin, J. H., Choi, G. Y., & Lee, J. (2021). Identifying Frequently Used NANDA-I Nursing Diagnoses, NOC Outcomes, NIC Interventions, and NNN Linkages for Nursing Home Residents in Korea. International journal of environmental research and public health, 18(21), 11505. https://doi.org/10.3390/ijerph182111505
Taggart, C., Wereski, R., Mills, N. L., & Chapman, A. R. (2021). Diagnosis, Investigation, and Management of Patients with Acute and Chronic Myocardial Injury. Journal of clinical medicine, 10(11), 2331. https://doi.org/10.3390/jcm10112331 Case Study For Myocardial Infarction Assignment