I will be discussing 5 relevant nursing diagnoses related to a heart
attack. I will then go into detail about possible nursing interventions related
to one of the diagnoses.
1. Acute pain related to tissue ischemia. This can be evidenced by
patient reports of chest pain, patient expressing facial grimaces, changes in
level of consciousness, and changes in pulse or blood pressure.
2. Activity intolerance related to imbalance between myocardial oxygen
supply and demand. This can be evidenced by changes in pulse and blood pressure
on exertion, having irregular heartbeats, changes in skin color, feeling weak,
and feeling chest pain on exertion.
3. Anxiety related to threat to change in health. This can be evidenced
by increased tension and restlessness, feelings of uncertainty, and expressing
concern about recent events.
4. Decreased cardiac output related to heart muscle damage. This can be
evidenced by changes in heart rate and blood pressure, changes in skin color,
chest pain on exertion.
5. Risk for Ineffective tissue perfusion related to interrupted blood
flow.
(Myocardial Infarction: Heart Attack, 2015)
For decreased cardiac output related to heart muscle damage, outcomes
and goals include patient having adequate cardiac output and tissue perfusion
as demonstrated by maintain BP within normal limits, maintaining warm and dry
skin, having regular cardiac rhythm, having clear lung sounds, and strong
bilateral, equal peripheral pulses, having adequate urinary output and
decreased frequency of angina (Myocardial Infarction: Heart Attack, 2015).
Nursing interventions include:
Assessing for signs of decreased cardiac output through heart rate, blood
pressure, skin color, temperature, weakness and fatigue, crackles, cyanosis of
skin.
Perform actions to reduce cardiac workload such as maintain appropriate
levels of physical activity and creating a soothing environment. Restricting activity
will reduce oxygen demands and prevent the heart from overworking itself.
Administer medications as ordered by the health care provider in order
to maintain blood pressure, cholesterol, decrease heart rate and myocardial oxygen
requirements, and reduce incidence of ventricular thrombus formation.
Educating the patient about the importance of maintaining the
recommended diet from his healthcare provider and the positive effects this
will have on his heart.
(Myocardial Infarction: Heart Attack, 2015)
Myocardial Infarction: Heart Attack – nurseslabs. (2015). Retrieved
February 2/18/15. From http://nurseslabs.com/7-myocardial-infarction-heart-attack-nursing-care-plans/
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