Understanding Myocardial Infarction (MI) is Crucial for the NCLEX Exam
Welcome, nursing students and NCLEX preppers, to our Myocardial Infarction (MI) NCLEX review!
In this blog post, we will delve into the critical aspects of myocardial infarction, commonly known as a heart attack, to equip you with the knowledge and confidence needed to excel in your NCLEX exam. Understanding the symptoms, nursing interventions, and management of MI is vital for providing top-notch patient care as future nurses. Plus, we have an exclusive FREE download available to enhance your learning experience.
Let's dive into a quick NCLEX review of Myocardial Infarction (MI)!
Myocardial Infarction Overview
Sudden restriction of blood supply to a portion of the heart causing ischemia and death to the muscle tissue
General Information on Myocardial Infarction
- Causes
- Coronary artery disease and thrombosis
Nursing Assessment for Myocardial Infarction
- Subjective Data
- Chest pain unrelieved by rest
- Skin pale, diaphoretic, mottled, nausea, anxiety, SOB, and palpitations that worsen with activity
- Objective Data
- Might be hypotensive/bradycardic
- ST-elevation on 12-Lead (STEMI)
- Elevated Troponins (most sensitive), elevated
CK-MB & CK
Therapeutic Management for Myocardial Infarction
- Medication Management (anticipated mediation)
- Thienopyridines (clopidogrel)
- Heparin
- Renin-Angiotensin Blockade (ARBS or Ace inhibitors)
- Oxygen
- Morphine (only if indicated by facility)
- Beta Blockers
- Nitroglycerine (per facility policy)
- Monitor EKG
- Rest – decrease O2 demands of the heart
- Anticipate Provider Orders
- 12-Lead EKG
- Cardiac Enzymes q3h x 4
- Thrombolytics unless contraindicated
- Percutaneous Transluminal Coronary Angioplasty (PTCA)--> opens clogged arteries
Nursing Case Study for Myocardial Infarction
Patient Profile:
- Name: John Anderson
- Age: 58
- Gender: Male
- Medical History: Hypertension, Hyperlipidemia, Smoker
- Occupation: Construction Worker
Chief Complaint:
John arrives at the emergency department complaining of severe chest pain that started while he was at work. He describes the pain as a crushing sensation in the center of his chest that radiates to his left arm and jaw. He also feels nauseous and sweaty. John states that the pain began about an hour ago and has not improved with rest.
Assessment Findings:
- Vital signs: Blood pressure 180/100 mmHg, Heart rate 110 bpm, Respiratory rate 22 breaths/min, Oxygen saturation 94% on room air, Temperature 98.4°F (36.9°C).
- Cardiovascular: Irregular heart rhythm, S4 heart sound present, decreased peripheral pulses.
- Respiratory: Clear lung sounds bilaterally.
- Skin: Cool, pale, and diaphoretic.
- Blood glucose level: 150 mg/dL.
Nursing Interventions:
- Prioritize assessing John's airway, breathing, and circulation (ABCs).
- Administer supplemental oxygen to maintain oxygen saturation above 95%.
- Obtain a 12-lead electrocardiogram (ECG) to evaluate for ST-segment elevation, indicating myocardial ischemia.
Plan of Care:
- Administer oxygen at 2-4 L/min via nasal cannula to maintain oxygen saturation above 95%.
- Administer aspirin 325 mg chewable tablet and nitroglycerin as prescribed.
- Monitor John's vital signs and pain level closely.
- Prepare John for possible PCI and communicate with the interventional cardiologist.
Outcome:
John's ECG shows ST-segment elevation, indicating an ST-elevation myocardial infarction (STEMI). He is urgently taken to the cardiac catheterization lab, where PCI is performed to open the blocked coronary artery. After the procedure, John's symptoms improve, and he is transferred to the cardiac care unit for further monitoring and recovery.
Conclusion and Free Download
This Myocardial Infarction review provides essential knowledge for approaching the NCLEX with confidence. Understanding symptoms, interventions, and considerations related to Myocardial Infarction is crucial for delivering exceptional patient care as a nurse.
Are you looking for more must-know NCLEX review topics? Download our free eBook, "NCLEX Flash Notes: 77 Must-Know Nursing Topics for the NCLEX," by simply providing your email address below. I'll send you a complimentary copy straight to your inbox!
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Happy Nursing!