VIRGEN MILAGROSA UNIVERSITY FOUNDATION

COLLEGE OF NURSING
NCM 112 RLE
ACTIVITY NO.2

1. Explain the difference between Myocardial Ischemia and Myocardial Infarction based basic
pathophysiology and its clinical manifestations? (10 points)

2. Discuss briefly the classification of MI according to the heart muscle involve and according to its
location. (10 points)

3. What are the expected laboratory and diagnostics applicable for both Myocardial ischemia and
Myocardial infarction and its results? (10 points)

4. What are the nursing interventions to be employed if a patient had Myocardial infarction? (10
points)

5. What are the expected medications to be prescribed by citing some examples and give the
reasons or mechanism of actions why it will be given? (10 points)

Case 1 - Woman with Ischemic Heart Disease/ CAD

A 67-year-old woman sought emergency medical care due to prolonged chest pain. In April 2009
the patient had prolonged chest pain and at that time she sought medical care. A nurse on duty as
the patient complaints and tells that she had chest pain with PRS of 8/10. You also observe that
she’s having shortness of breathing with initial VS of the following: RR=28bpm, HR= 115 bpm,
and BP= 170/100 mmHg and oxygen saturation of 90%. Based from this findings, you relayed it
to the doctor on duty and she was advised to be admitted because she is experiencing
myocardial ischemia secondary to CAD. Moreover, the patient tells the nurse that she had
hypertension, diabetes mellitus, hyperlipidemia and was a smoker for 20 years.
As part of the her history, she also confessed that she is taking metropolol 25 mg PO qd,
Nitroglycerin SL PRN, and Lipitor 40 mg/tab OD.
Initial laboratory test was conducted and showed hemoglobin 13 g/dL, hematocrit 40%, MCV 91
fL, leukocytes 12,400/mm3 (66% neutrophils, 1% eosinophils, 1% basophils, 19% lymphocytes
and 13% monocytes), 421,000/mm3, total cholesterol 228 mg/dL, HDL-cholesterol 35 mg / dL,
LDL-cholesterol 280 mg/dL, triglycerides 300 mg/dL, CK-MB mass 5.63 ng / mL, Troponin I
0.21 ng/mL, urea 33 mg/dL, creatinine 0.66 mg/dL, sodium 137 mEq/L, and potassium 3.4
mEq/L. Venous blood gasometry showed pH 7.46, pCO2 39.3 mmHg, pO2 36.3 mmHg,
O2 saturation 62.7%, bicarbonate 27.7 mEq/L and base excess 4.1 mEq/L.
Approximately two hours after hospital admission, she had seizures and cardiac arrest with
pulseless electrical activity, reversed in 5 min after giving prompt medical treatment.

Based from this case situation, create a Nursing Care plan base from the format below.
Indicate independent, dependent and interdependent nursing interventions

Assessment Nursing Planning Nursing Evaluation

Diagnosis Interventions