Role of a Nurse to Manage a Patient with Myocardial Infarction: This presentation seeks to scrutinize the role played by a nurse in providing care to a patient with myocardial infarction (MI) on myriad levels. First, there should be careful assessment of all symptoms displayed by an MI patient including his/her physical condition. Nursing assessment should be based on careful physical examination of the patient from recording vitals to noting down all symptoms. Most important symptom which should be sought by a nurse is a crushing or death-like retrosternal chest pain (NHS choices 2014). A nurse should clearly inquire the patient about this pain, when it started, its range etc. Any signs of irregular heartbeat, sweating, nausea, and pallor should be noticed. Next, diagnostic evaluation is important in which the nurse should look for ST segment elevation or depression to decide if it is ST-elevation MI or non-ST elevation MI (Nursing Care Plans 2014).
ECG results and vital signs should be recorded. This is an important feature of nursing intervention for MI. Oxygen supplementation should be immediately started in case the patient is experiencing severe dyspnoea. ECG should be performed during acute pain attack also (Cardiac Care Network 2013). Fluid retention and high cholesterol levels can create a problem, so diet and lifestyle changes should be strictly maintained to reduce both fluid retention and cholesterol levels (Mok et al. 2013, p. 256). Before giving any medicine to the patient, the nurse should carefully evaluate if he/she is allergic to the medicine or not. Many MI patients can be allergic to aspirin in which case it should not be given. Statins should be given to reduce cholesterol level and ACE inhibitors should be administered to reduce blood pressure level. Beta-blockers should also be given to reduce workload of the heart, but care should be taken when giving beta-blockers in patients who have a very slow pulse (Kenny 2012b).
In context of ethical consideration, obtaining informed consent of the patient is critically important (Andreae, Ekstedt & Snellman 2011). Patient autonomy or respect for what a patient wants is also an important ethical consideration. Also in the care of MI patients, it should be ensured that resources are fairly distributed and no harm is provided to the patient due to carelessness. Elderly patients with MI often experience high levels of anxiety, but they are not provided psychological care. So, it is important for a nurse to ensure psychological help for very anxious patients (NHS 2007). Anxiety increases both heart rate and blood pressure level. Anxiety is often exacerbated by lack of information (Simon 2014). So, in order to provide psychological care, a nurse should be very attentive to the patient and should carefully explain every step of the care plan to keep him/her aware of everything. Women, in particular, experiencing atypical symptoms should be assisted by a nurse to help them choose a coping mechanism (Zbierajewski-Eischeid & Loeb 2009, p. 2). Patients should also be counselled by nurses about healthcare costs of NHS. They should be educated about all treatment costs. Every patient’s circumstances are different, so the nurse should discuss with the patient which treatment plan will be best for him/her in accordance with his/her economic condition (Kenny 2012a).
References:
Andreae, C, Ekstedt, M & Snellman, I 2011, ‘ Patients’ Participation as It Appears in the Nursing Documentation, When Care Is Ruled by Standardized Care Plans’, ISRN Nursing, vol. 2011, viewed 11 May 2014, Cardiac Care Network 2013, ‘ MANAGEMENT OF ACUTE CORONARY SYNDROMES’, viewed 11 May 2014, Kenny, T 2012a, ‘ After a Myocardial Infarction’, viewed 11 May 2014, Kenny, T 2012b, ‘ Medication after a Myocardial Infarction’, viewed 11 May 2014, Mok, VK, Sit, JW, Tsang, AS, Chair, SY, Cheng, TL & Chiang, CS 2013, ‘ A controlled trial of a nurse follow-up dietary intervention on maintaining a heart-healthy dietary pattern among patients after myocardial infarction’, The Journal of Cardiovascular Nursing, vol. 28, no. 3, pp. 256-66.
NHS 2007, ‘ MI: secondary prevention’, viewed 11 May 2014, NHS choices 2014, ‘ Heart attack’, viewed 11 May 2014, Nursing Care Plans 2014, ‘ 7 Myocardial Infarction (Heart Attack) Nursing Care Plans’, viewed 11 May 2014, Simon, H 2014, ‘ Stress and Anxiety’, The New York Times, viewed 11 May 2014, Zbierajewski-Eischeid, SJ & Loeb, SJ 2009, ‘ Myocardial infarction in women: promoting symptom recognition, early diagnosis, and risk assessment’, DCCN, vol. 28, no. 1, pp. 1-6.
