A NURSING CASE STUDY ON

MYOCARDIAL INFARCTION
BSN 4G GROUP 1 SUBGROUP 2
INTRODUCTION
Advocating the promotion of life
through healthy lifestyle has
come to it’s decisive moment of
becoming inevitable to best
respond to the striking and
alarming incidence of
cardiovascular disease,
specifically myocardial
infarction.
Indeed, it is a matter of
choice. Besides, this
will guide us in the
glory that will
compensate us or else
suffer the burden of the
consequence. There is
no such thing as free
item.
One is given to you
because one is taken from
the other. One cannot be
superior over the other.
One should compromise to
accommodate the need of
the other. This is what set
thing straight – the balance
of nature is the key to
harmony.
Globally, it is anticipated
that both morbidity and
mortality rates from
heart disease will double
between 1990 and 2020.
The demand for care is highly increasing
although out the world and so, we as future
nurses must respond to the challenges of a
changing world. How can we respond in an
appropriate and useful way? Upon thinking
about the solutions to our pressing
problems and concerns, the realization of
conducting a study, even though some may
find it just an addition to our pile of burdens
as students, seemed to be the best way
after all. For we, are the hope of the future
generations.
We live in a period where knowledge
equals power. If we don’t conform
and go with the flow, we might just
get left behind. In line with this, we
choose our client Ireneo Sarad, 48
years old of ICU Complex cubicle 21
with the diagnosis of Myocardial
infarction. The case succumb for our
better understanding of the disease
process. It is a sort of application of
theories in to real life practice
As we go along the
processs, Myocardial
infarction (MI) or acute
myocardial infarction (AMI),
commonly known as a heart
attack, is the interruption of
blood supply to part of the
heart, causing heart cells to
die.
As a matter of fact, the
prevalence of heart attack
according to WHO for May
2009 - 2010, 7.5 million
people suffers Myocardial
infarction worldwide annually.
12 460 cases of MI are
recorded last 2009 here in the
Philippines. Davao Region
recorded cases on Myocardial
infarction runs up to 1206
(29.8%) as of 2009.
This educational manuscript
can be of great help to the
nursing education since it will
pave way to provide further
information of the disease
process, its treatment and
prevention.
To the nursing practice on the
other hand, this may help the
health team on the apt
assessment, diagnosis as
well relevant and well-timed
interventions.
This may also be of great
inspiration on the nursing
research as a basis of their
future studies and
experiments.
With this case study, we hope
that we can improve the health
care system in our own little and
hone us in becoming a holistic
angel in the sickroom as
equipped with competent
knowledge, exemplary skill and
exceptional attitude – a start of
something new that will
absolutely enrich the humanity
OBJECTIVES
 GENERAL OBJECTIVE

That within our 4 weeks span of

clinical exposure at San Pedro Hospital
Intensive Care Unit Complex for our
Elective Nursing ICU – Rotation, we, the
BSN 4G GROUP 2 SUBGROUP 1 will
be able to come up with a
comprehensive case study. This will
gear us towards the acquisition of better
understanding about a certain disease
that is essential in the empowerment of
our advocacies in the field of nursing.
 SPECIFIC OBJECTIVES
That within the course of this case study;
specifically, we will be able to:
a. select as client as our subject for the
case study;
b. establish a good interpersonal
relationship with the client and her
family to gain trust and cooperation;
c. gather reliable information through
assessment, interview and chart
reading.
d. introduce our study and present its
implications in the field of nursing
practice, education and research;
e. formulate general and specific
objectives that is specific, measurable,
attainable, realistic and time-bounded;
f. gather personal and medical data
about our client and his condition;
g. review the past and present health
status of our client;
h. trace our client’s family lineage up to
the third generation;
i. identify genetic factors that
contributes to the client’s present
condition;
j. identify the task accomplished by
our client in relation to the theories of
growth and development of Erik Erikson
and Robert Havighurst;
k. define the complete diagnosis of our
client with atleast 5 references;
l. perform a complete cephalocaudal
assessment of the client, noting the
deviations from the normal;
m. discuss the anatomy and physiology of the
organs involved in the disease process;
n. identify the etiology of the disease including
the predisposing and precipitating factors;
o. trace the pathophysiology together with the
symptomatology of the disease;
p. enumerate the drugs taken by the client,
their classification, mode of action,
indications, contraindications, interactions,
side effects, adverse reaction and
corresponding nursing responsibilities;
q. interpret the results of the diagnostic
examination as we render the appropriate
nursing interventions.
r. present the actual and possible medical
and surgical management of the disease;
s. formulate 2 potential and 3 actual proactive
nursing care plans intended to meet the
needs of our client;
t. list the health teachings for discharge
planning concerning the medications,
exercises, treatment, hygiene, outpatient
treatment and the diet;
u. present a prognosis on the disease
condition of the client; and
v. List all references used in the completion
of this case study.
DISCHARGE PLANNING
 Medication

Encourage patient to participate with treatment

regimen and to comply with the medications being
prescribed.
® Compliance to treatment regimen and
medications contribute to faster recovery
Discuss with the patient and the family the
purpose and side effects of medications especially
in long term therapy.
® Understanding of the therapeutic needs and
importance of prompt reporting of side effects can
prevent occurrence of drug related complications.
Adequate information and understanding that side
effects are common and often subside with time
enhances cooperation with treatment plan.
 Advice not to take OTC drugs without
consulting the doctor.
® It may alter the absorption and effects of
other drugs taken
Emphasize the importance of taking drug
according to the schedule and doses.
® To ensure effectiveness of drug
Inform them that the drugs may have adverse
effects which are undesirable or unexpected.
® Adverse reaction is with life threatening
effects to the patient. Immediate consultation is
necessary to prevent untoward injuries brought
about by it’s adverse reactions that might cause
death
 Exercise

Emphasize the need to maintain regular

exercise and activities as long as the patient can
tolerate.
® To maintain muscle strength and motility and
promote good circulation of the body system.
Instruct the family members to do passive
range of motion to patient to promote good
circulation if patient is unable to do it on his own.
® Exhaustion contributes to increase oxygen
demand of the heart, which may also increase in
cardiac workload.
Explain to the patient and family members the
effects of exercise to the body.
® To let the client know significance of having
exercise daily
 Treatment

Help the patient and family with

informed decision-making regarding the
possible treatment options method.
® To maintain the patient’s quality of life
during the course of his disease and end of
life treatment options.
Instruct family members and significant
others to provide a calm and restful
environment for the patient.
® It helps patient to be free from
pressure thus allowing patient to relax
 Physical and emotional rehabilitation
to the patient must include the family
members
® So that the family can discern and
understand the patient’s need and
learn to interpret and cope with the
behavioral changes.
Stress the importance of adhering to
the prescribed medications and
treatment regimen
® To prevent further relapse to
previous condition and more
exacerbation of the condition.
 Hygiene

Encourage patient to maintain proper

hygiene such as taking a bath everyday
and observe oral hygiene.
® Promotes cleanliness and comfort
Stress the importance of performing
proper hand washing before and after each
contact with dirty objects.
® Hand washing prevents the spread of
microorganism Encourage patient to clothe
with clean and decent clothes, as well as to
comb hair tidily
 Out patient follow up

The patient should know the time and date of

the next appointment with the physician.
® To assure the continuity of care.
Instruct patient to comply with follow-up visits
to physician.
® This is useful in re-evaluating the client’s
condition.
Advice family and patient to report at once the
occurrence of adverse effects of medications.
® This would allow for the discontinuation of
the current drug and the prescription of a new
drug. It would help prevent hypersensitivity and
anaphylactic reactions
 Diet

Provide supplemental vitamins and feedings.

® This may be necessary if the client food
intake is poor.
Encourage to limit fluid intake as ordered by
the physician.
® to prevent worsening of edema
Avoid drinking alcohol
® this will worsen the condition of the patient
Encourage patient to develop low salt
moderate fat diet.
® To avoid excessive sodium retention in the
body that causes high blood pressure.