Republic of the Philippines

University Vision
President Ramon Magsaysay State University
The President Ramon Iba, Zambales (Main Campus)
Magsaysay State University
shall be a progressive learner-
centered research university
recognized in the ASEAN
Region in 2020. Name: Allan Lyndon F. Larios Date:
University Mission
The President Ramon
BSN-3A
Magsaysay State University
shall primarily provide advance
and higher professional,
technical, and special
instructions in various
disciplines; undertake MYOCARDIAL INFARCTION
research, extension and
income generation programs
for the sustainable  What is all about Myocardial Infraction
development of Zambales, the
region and the country.
Myocardial infarction (MI), colloquially known as "heart attack," is caused by
College Goals
The PRMSU-College of decreased or complete cessation of blood flow to a portion of the myocardium.
Nursing aims to provide the
students appropriate practical Myocardial infarction may be"silent," and go undetected, or it could be a catastrophic
and theoretical competencies
in the practice of nursing event leading to hemodynamic deterioration and sudden death. Most myocardial
services. Expose students to
experiences which would infarctions are due to underlying coronary artery disease, the leading cause of death in the
provide them the opportunities
to reinforce skills in United States. With coronary artery occlusion, the myocardium is deprived of oxygen.
medical/nursing services.
Develop in the students the Prolonged deprivation of oxygen supply to the myocardium can lead to myocardial cell
passion from services and
concern for the medical needs death and necrosis. Patients can present with chest discomfort or pressure that can radiate
of our community. Undertake
research projects vis-a-vis the to the neck, jaw, shoulder, or arm. In addition to the history and physical exam,
development of newer and
better approaches in Nursing myocardial ischemia may be associated with ECG changes and elevated biochemical
and Nursing Education. At the
end of the program, 100 % of markers such as cardiac troponins. This activity describes the pathophysiology,
the graduates are expected to
pass the Philippine Nursing evaluation, and management of myocardial infarction and highlights the role of the
Licensure Examination above
the National Percentage Rate. interprofessional team in improving care for affected patients. In an MI, an area of the
College Specific myocardium is permanently destroyed because plaque rupture and subsequent thrombus
Objectives formation result in complete occlusion of the artery. The spectrum of ACS includes
1. Provide appropriate and
relevant medical services to unstable angina, non-ST-segment elevation MI, and ST-segment elevation MI.
the Filipino people in particular
and to those in dire need of
health care in general.  Pathophysiology
2. Undertake research projects
on the development of newer
and better approaches in
Nursing and Nursing
Unstable angina. There is reduced blood flow in a coronary artery, often due to rupture
Education
3. Pass licensure examinations
of an atherosclerotic plaque, but the artery is not completely occluded.
for Registered Nurses.
4. Become leaders in the field
of Medicine/Nursing Development of infarction. As the cells are deprived of oxygen, ischemia develops,
0919-069-9175 cellular injury occurs, and lack of oxygen leads to infarction or death of the cells.In each
online.con@prmsu.edu.ph
@prmsucollegeofnursing
case of MI, a profound imbalance exists between myocardial oxygen supply and demand.

COLLEGE OF NURSING
 Republic of the Philippines

University Vision
President Ramon Magsaysay State University
The President Ramon Iba, Zambales (Main Campus)
Magsaysay State University
shall be a progressive learner-
 Statistics and Epidemiology
centered research university
recognized in the ASEAN
Region in 2020. “Time is muscle”; this is the reflection of the urgency of appropriate treatments to
University Mission
improve patient outcome. Each year in the United States, nearly 1 million people have
The President Ramon
Magsaysay State University
acute MIs. One fourth of the people with the disease die of MI. Half of the people who
shall primarily provide advance
and higher professional,
die with acute MI never reach the hospital.
technical, and special
instructions in various
disciplines; undertake
 Sign & Symptoms
research, extension and
income generation programs
for the sustainable Some of the patients have prodromal symptoms or a previous diagnosis of CAD, but
development of Zambales, the
region and the country. about half report no previous symptoms.
College Goals
The PRMSU-College of Chest pain. This is the cardinal symptom of MI. Persistent and crushing substernal
Nursing aims to provide the
students appropriate practical pain that may radiate to the left arm, jaw, neck, or shoulder blades. Pain is usually
and theoretical competencies
in the practice of nursing
described as heavy, squeezing, or crushing and may persist for 12 hours or more.
services. Expose students to
experiences which would
Shortness of breath. Because of increased oxygen demand and a decrease in the
provide them the opportunities
to reinforce skills in
supply of oxygen, shortness of breath occurs.
medical/nursing services.
Develop in the students the
Indigestion. Indigestion is present as a result of the stimulation of the sympathetic
passion from services and
concern for the medical needs
nervous system.
of our community. Undertake
research projects vis-a-vis the
Tachycardia and tachypnea. To compensate for the decreased oxygen supply, the
development of newer and
better approaches in Nursing
heart rate and respiratory rate speed up.
and Nursing Education. At the
end of the program, 100 % of
Catecholamine responses. The patient may experience such as coolness in
the graduates are expected to
pass the Philippine Nursing
extremities, perspiration, anxiety, and restlessness.
Licensure Examination above Fever. Unusually occurs at the onset of MI, but a low-grade temperature elevation
the National Percentage Rate.
may develop during the next few days.
College Specific
Objectives
1. Provide appropriate and
relevant medical services to  Prevention
the Filipino people in particular
and to those in dire need of
A healthy lifestyle could help prevent the development of MI.
health care in general.
2. Undertake research projects
on the development of newer
and better approaches in
Exercise. Exercising at least thrice a week could help lower cholesterol levels that
Nursing and Nursing
Education
cause vasoconstriction of the blood vessels.
3. Pass licensure examinations
for Registered Nurses.
Balanced diet. Fruits, vegetables, meat and fish should be incorporated in the
4. Become leaders in the field
of Medicine/Nursing
patient’s daily diet to ensure that he or she gets the right amount of nutrients he or she
0919-069-9175
needs.
online.con@prmsu.edu.ph Smoking cessation. Nicotine causes vasoconstriction which can increase the pressure
@prmsucollegeofnursing
of the blood and result in MI.

COLLEGE OF NURSING
 Republic of the Philippines

University Vision
President Ramon Magsaysay State University
The President Ramon Iba, Zambales (Main Campus)
Magsaysay State University
shall be a progressive learner-
centered research university
recognized in the ASEAN
 Assessment and Diagnostic Findings
Region in 2020.

University Mission
The diagnosis of MI is generally based on the presenting symptoms.
The President Ramon
Magsaysay State University
shall primarily provide advance  Patient history. The patient history includes the description of the presenting
and higher professional,
technical, and special symptoms, the history of previous cardiac and other illnesses, and the family history
instructions in various
disciplines; undertake of heart diseases.
research, extension and
income generation programs  ECG. ST elevation signifying ischemia; peaked upright or inverted T wave indicating
for the sustainable
development of Zambales, the injury; development of Q waves signifying prolonged ischemia or necrosis.
region and the country.
 Cardiac enzymes and isoenzymes. CPK-MB (isoenzyme in cardiac muscle):
College Goals Elevates within 4–8 hr, peaks in 12–20 hr, returns to normal in 48–72 hr.
The PRMSU-College of
Nursing aims to provide the
students appropriate practical
 LDH. Elevates within 8–24 hr, peaks within 72–144 hr, and may take as long as 14
and theoretical competencies
in the practice of nursing
days to return to normal. An LDH1 greater than LDH2 (flipped ratio) helps
services. Expose students to
experiences which would
confirm/diagnose MI if not detected in acute phase.
provide them the opportunities
to reinforce skills in
 Troponins. Troponin I (cTnI) and troponin T (cTnT): Levels are elevated at 4–6 hr,
medical/nursing services.
Develop in the students the
peak at 14–18 hr, and return to baseline over 6–7 days. These enzymes have increased
passion from services and
concern for the medical needs
specificity for necrosis and are therefore useful in diagnosing postoperative MI when
of our community. Undertake
research projects vis-a-vis the
MB-CPK may be elevated related to skeletal trauma.
development of newer and
better approaches in Nursing
 Myoglobin. A heme protein of small molecular weight that is more rapidly released
and Nursing Education. At the
end of the program, 100 % of
from damaged muscle tissue with elevation within 2 hr after an acute MI, and peak
the graduates are expected to
pass the Philippine Nursing
levels occurring in 3–15 hr.
Licensure Examination above
the National Percentage Rate.
 Electrolytes. Imbalances of sodium and potassium can alter conduction and
compromise contractility.
College Specific
Objectives  WBC. Leukocytosis (10,000–20,000) usually appears on the second day after MI
1. Provide appropriate and
relevant medical services to because of the inflammatory process.
the Filipino people in particular
and to those in dire need of  ESR. Rises on second or third day after MI, indicating inflammatory response.
health care in general.
2. Undertake research projects  Chemistry profiles. May be abnormal, depending on acute/chronic abnormal organ
on the development of newer
and better approaches in function/perfusion.
Nursing and Nursing
Education  ABGs/pulse oximetry. May indicate hypoxia or acute/chronic lung disease
3. Pass licensure examinations
for Registered Nurses. processes.
4. Become leaders in the field
of Medicine/Nursing  Lipids (total lipids, HDL, LDL, VLDL, total cholesterol, triglycerides,
0919-069-9175 phospholipids). Elevations may reflect arteriosclerosis as a cause for coronary
online.con@prmsu.edu.ph
@prmsucollegeofnursing narrowing or spasm.
 Chest x-ray. May be normal or show an enlarged cardiac shadow suggestive of HF
or ventricular aneurysm.
 Two-dimensional echocardiogram. May be done to determine dimensions of
chambers, septal/ventricular wall motion, ejection fraction (blood flow), and valve
configuration/function.

COLLEGE OF NURSING
 Republic of the Philippines

University Vision
President Ramon Magsaysay State University
The President Ramon Iba, Zambales (Main Campus)
Magsaysay State University
shall be a progressive learner-
 Nuclear imaging studies: Persantine or Thallium. Evaluates myocardial blood flow
centered research university
recognized in the ASEAN
and status of myocardial cells, e.g., location/extent of acute/previous MI.
Region in 2020.
 Cardiac blood imaging/MUGA. Evaluates specific and general ventricular
University Mission
The President Ramon
performance, regional wall motion, and ejection fraction.
Magsaysay State University
shall primarily provide advance
 Technetium. Accumulates in ischemic cells, outlining necrotic area(s).
and higher professional,
technical, and special
 Coronary angiography. Visualizes narrowing/occlusion of coronary arteries and is
instructions in various
disciplines; undertake
usually done in conjunction with measurements of chamber pressures and assessment
research, extension and
income generation programs
of left ventricular function (ejection fraction). Procedure is not usually done in acute
for the sustainable
development of Zambales, the
phase of MI unless angioplasty or emergency heart surgery is imminent.
region and the country.
 Digital subtraction angiography (DSA). Technique used to visualize status of
College Goals arterial bypass grafts and to detect peripheral artery disease.
The PRMSU-College of
Nursing aims to provide the  Magnetic resonance imaging (MRI). Allows visualization of blood flow, cardiac
students appropriate practical
and theoretical competencies chambers or intraventricular septum, valves, vascular lesions, plaque formations,
in the practice of nursing
services. Expose students to areas of necrosis/infarction, and blood clots.
experiences which would
provide them the opportunities  Exercise stress test. Determines cardiovascular response to activity (often done in
to reinforce skills in
medical/nursing services. conjunction with thallium imaging in the recovery phase).
Develop in the students the
passion from services and
concern for the medical needs
of our community. Undertake
research projects vis-a-vis the
development of newer and
better approaches in Nursing  Treatment/ Intervention
and Nursing Education. At the
end of the program, 100 % of
the graduates are expected to Nursing Interventions
pass the Philippine Nursing
Licensure Examination above
the National Percentage Rate.  Nursing interventions should be anchored on the goals in the nursing care plan.
College Specific
Objectives
1. Provide appropriate and
relevant medical services to
the Filipino people in particular  Administer oxygen along with medication therapy to assist with relief of symptoms.
and to those in dire need of
health care in general.  Encourage bed rest with the back rest elevated to help decrease chest discomfort and
2. Undertake research projects
on the development of newer dyspnea.
and better approaches in
Nursing and Nursing
Education
 Encourage changing of positions frequently to help keep fluid from pooling in the
3. Pass licensure examinations bases of the lungs.
for Registered Nurses.
4. Become leaders in the field
of Medicine/Nursing
 Check skin temperature and peripheral pulses frequently to monitor tissue perfusion.
0919-069-9175
 Provide information in an honest and supportive manner.
online.con@prmsu.edu.ph
 Monitor the patient closely for changes in cardiac rate and rhythm, heart sounds,
@prmsucollegeofnursing
blood pressure, chest pain, respiratory status, urinary output, changes in skin color,
and laboratory values.

COLLEGE OF NURSING
 Republic of the Philippines

University Vision
President Ramon Magsaysay State University
The President Ramon Iba, Zambales (Main Campus)
Magsaysay State University
shall be a progressive learner-
centered research university
recognized in the ASEAN
Region in 2020. Pharmacologic Therapy
University Mission
The President Ramon Morphine administered in IV boluses is used for MI to reduce pain and anxiety.
Magsaysay State University
shall primarily provide advance
and higher professional, ACE Inhibitors. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II
technical, and special
instructions in various to decrease blood pressure and for the kidneys to secrete sodium and fluid, decreasing the
disciplines; undertake
research, extension and oxygen demand of the heart.
income generation programs
for the sustainable
development of Zambales, the Thrombolytics. Thrombolytics dissolve the thrombus in the coronary artery,allowing
region and the country.
blood to flow through the coronary artery again, minimizing the size of the infarction and
College Goals
The PRMSU-College of preserving ventricular function.
Nursing aims to provide the
students appropriate practical
and theoretical competencies Nursing Management
in the practice of nursing
services. Expose students to
experiences which would The nursing management involved in MI is critical and systematic, and efficiency is
provide them the opportunities
to reinforce skills in needed to implement the care for a patient with MI.
medical/nursing services.
Develop in the students the
passion from services and Nursing Assessment
concern for the medical needs
of our community. Undertake
research projects vis-a-vis the
development of newer and
One of the most important aspects of care of the patient with MI is the assessment.
better approaches in Nursing
and Nursing Education. At the
end of the program, 100 % of
the graduates are expected to
pass the Philippine Nursing
Licensure Examination above  Assess for chest pain not relieved by rest or medications.
the National Percentage Rate.
 Monitor vital signs, especially the blood pressure and pulse rate.
College Specific
Objectives  Assess for presence of shortness of breath, dyspnea, tachypnea, and crackles.
1. Provide appropriate and
relevant medical services to  Assess for nausea and vomiting.
the Filipino people in particular
and to those in dire need of  Assess for decreased urinary output.
health care in general.
2. Undertake research projects  Assess for the history of illnesses.
on the development of newer
and better approaches in  Perform a precise and complete physical assessment to detect complications and
Nursing and Nursing
Education changes in the patient’s status.
3. Pass licensure examinations
for Registered Nurses.  Assess IV sites frequently.
4. Become leaders in the field
of Medicine/Nursing

0919-069-9175  Emergent Percutaneous Coronary Intervention

online.con@prmsu.edu.ph
@prmsucollegeofnursing
 The procedure is used to open the occluded coronary artery and promote reperfusion
to the area that has been deprived of oxygen.
 PCI may also be indicated in patients with unstable angina and NSTEMI for patients
who are at high risk due to persistent ischemia.

COLLEGE OF NURSING
 Republic of the Philippines

University Vision
President Ramon Magsaysay State University
The President Ramon Iba, Zambales (Main Campus)
Magsaysay State University
shall be a progressive learner-
centered research university
recognized in the ASEAN
 Diagnosis
Region in 2020.

University Mission
Based on the clinical manifestations, history, and diagnostic assessment data, major
The President Ramon
Magsaysay State University
nursing diagnoses may include.
shall primarily provide advance
and higher professional,
technical, and special
instructions in various
disciplines; undertake
research, extension and  Ineffective cardiac tissue perfusion related to reduced coronary blood flow.
income generation programs
for the sustainable  Risk for ineffective peripheral tissue perfusion related to decreased cardiac output
development of Zambales, the
region and the country. from left ventricular dysfunction.
College Goals  Deficient knowledge related to post-MI self-care.
The PRMSU-College of
Nursing aims to provide the
students appropriate practical
and theoretical competencies  Health Education/ Health teaching
in the practice of nursing
services. Expose students to The most effective way to increase the probability that the patient will implement
experiences which would
provide them the opportunities a self-care regimen after discharge is to identify the patient’s priorities.
to reinforce skills in
medical/nursing services.
Develop in the students the
passion from services and  Education. This is one of the priorities that the nurse must teach the patient
concern for the medical needs
of our community. Undertake about heart-healthy living.
research projects vis-a-vis the
development of newer and  Home care. The home care nurse assists the patient with scheduling and
better approaches in Nursing
and Nursing Education. At the keeping up with the follow-up appointments and with adhering to the
end of the program, 100 % of
the graduates are expected to prescribed cardiac rehabilitation management.
pass the Philippine Nursing
Licensure Examination above  Follow-up monitoring. The patient may need reminders about follow-up
the National Percentage Rate.
monitoring including periodic laboratory testing and ECGs, as well as
College Specific general health screening.
Objectives
1. Provide appropriate and  Adherence. The nurse should also monitor the patient’s adherence to
relevant medical services to
the Filipino people in particular dietary restrictions and prescribed medications.
and to those in dire need of
health care in general.
2. Undertake research projects
on the development of newer  Nursing consideration
and better approaches in
Nursing and Nursing  Individual findings.
Education
3. Pass licensure examinations  Vital signs, cardiac rhythm, presence of dysrhythmias.
for Registered Nurses.
4. Become leaders in the field
of Medicine/Nursing
 Plan of care and those involved in planning.
0919-069-9175
 Teaching plan.
online.con@prmsu.edu.ph
 Response to interventions, teaching, and actions performed.
@prmsucollegeofnursing
 Attainment or progress towards desired outcomes.
 Modifications to plan of care.

COLLEGE OF NURSING