ACUTE

ANTERIOR
MeaninWALL
-An anterior wall myocardial infarction
NURSING DIAGNOSIS
g MYOCARD
occurs
usually
when anterior myocardial tissue
supplied by the left anterior -Acute Pain related to myocardial ischemia
descending coronary artery suffers injuryresulting
due from coronary artery occlusion.
to lack of blood supply. -Ineffective Tissue Perfusion related to thrombus
in coronary artery.
IAL -Anxiety and Fear related to hospital admission
and fear of death.

CauseINFARCTIO Nursing Management

 Vasospasm. This is the sudden
Placed on a semi-fowler’s position with Oxygen inhalation at 3-4
constriction or narrowing of the


N
coronary artery.
Decreased oxygen supply. 
liters/ min via nasal cannula, Administer oxygen along with
medication therapy to assist with relief of symptoms
Assess pain status frequently with pain scale
 Increased demand for oxygen. 
Assess hemodynamic status including BP, HR, LOC, skin color, and
temperature (every 5 minutes during with pain; every 15 minutes)
Clinical Monitor continuous ECG to detect dysrhytmias
Perform 12-lead ECG immediately with new pain or changes in level
-Chest pain -he describes it as “pain under
my left chest that radiates to my left arm”. He rates of pain • Monitor respirations, breath sounds, and input and output to
the pain as an 8 on a scale of 1 to 10. He looks detect early signs of heart failure
diaphoretic and pale. Monitor O2 saturation and administer O2 as prescribed
-Tachycardia and tachypnea. Keep client limited fluid intake at 800 cc/shift, on strict bed rest with
-Sligth shortness of breath and crackles at
the bases with. Because of increased
oxygen demand and a decrease in the
Medical
no bathroom privileges with restrictions on having visitors.
Provide a calm environment and reassure client and family to
decrease stress, fear and anxiety
PHASES OF
supply of oxygen, shortness of breath occurs.

REHABILITATI
/Surgica
Laboratory ON cardiogenic pulmonary l
Pharmacologic Therapy- Daily medications are Aspirin 80 mg once
daily after breakfast, Isosorbide dinitrate 10 mg 3x a day,
Chest X ray shows
Simvastatin 20 mg at bedtime, and Enalapril 10mg daily.
edema.
Findings
FOLLOWING Phase I: Hospital
12 lead ECG with progressive ST elevation in
lead V2 to V5.
MYOCARDIAL
Troponin I Test result of 0.9 ng/mL,
Interven Angioplasty and stent placement (percutaneous coronary
revascularization)
Coronary artery by pass surgery.

INFARCTION tions
 Occurs while the patient is still hospitalised
 Activity level depends on severity of angina or MI
 Patient may initially sit up on bed or chair; perform range of motion exercise and self-care (walking, shaving) and
progress to ambulation in hallway and limited stair climbing.
 Mr. MS was relieved from his anxiety after explaining his condition and treatment.

Phase II: Early recovery

 Begins after the patient is discharged.

 Activity level is gradually increased and the supervision of the cardiac rehabilitation team and with ECG monitoring. He
was monitored for signs of reperfusion: return of ST segment to baseline and reperfusion dysrhythmias
 Team may suggest that physical activity (e.g. walking) be initiated at home.
 Information regarding risk factor reduction is provided at this time.

Phase III: Late recovery

 Long term maintenance program

 Individual physical activity programs are designed and implemented at home, a local gym or the rehabilitation centre.
 Patient and family possibly restructure lifestyle and roles.
 Lifestyle changes should become lifelong habits.
 Medical supervision is still recommended.