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QUESTION
Acute MI
- The patient is presenting to the ICU with a diagnosis of heart attack and all examinations done
on him also indicate that. In a study done by two Nurse Practitioners, they found that myocardial
infarction occurs in 30%-50% of patients (Webner & Marzlin 2019). He has been given all these
different medications to manage his symptoms, but most importantly we need to assess heart and
respiratory rate prior to administering morphine. With that being said, now would also be a good
time to obtain the patient’s medical history as well.
Additionally, the patient should be informed that he was given lidocaine hydrochloride
intravenously for acute management of his ventricular arrhythmia and some side effects include
hypotension, swelling, nausea, and vomiting. He should also be advised that atenolol was given
orally to reduce the amount of work the heart muscles had to do in order to push blood. It is
medicine usually given after a heart attack. It is also important to note and inform the patient that
the medications might make him sleepy and that is okay.
Lastly, the nurse should be alert and able to assess that the most adverse effects would be
respiratory depression or arrest. This is due to the fact that morphine is an opioid and is known to
cause hypoxia and hypotension (Bouida et al., 2019).
2.If I am a register nurse working in the intensive care unit (ICU), and I must admit a client with
the diagnosis of acute myocardial infarction. The first thing I would do is the assessments prior
to administer any medication. As well to check all the vital signs that are within the limit and
review any allergies. However, as the nurse in charge of this client I would ask too many
questions that can be related to any signs of heart attack. Primarily, I would do an
electrocardiogram (ECG) and the chest pain level. Also, I would ask if he know what might have
caused the chest pain and if the pain has lasted longer than 30 minutes and toward the back.
Although COVID-19 and other respiratory virus infections are associated with acute myocardial
infarction and other cardiovascular events. To date there are few reports of ST-segment elevation
myocardial infarction caused by type 1 myocardial infarction in patients with COVID-19. Also,
it seems myocardial ischemia (or infarction) accounts for a major part of the cardiac involvement
observed in this disease. (Ramandi, 2020)
However, if different drugs are prescribed to a patient, my role as a nurse is to explain and keep
the patient aware of his medications and reinforce of teaching about the purpose of what is
prescribed. Such as heparin is an anticoagulant that prevents the formation of blood clots.
Atenolol and aspirin are used to treat and prevent heart attacks, strokes, and chest pain. Aspirin
oral decreases effects of atenolol oral by opposing drug effects. As well as lidocaine is
sometimes used to treat irregular heart rhythms that may signal a possible heart attack. In
Mexico, there has been an increase in the risk of cardiovascular disease due to rising life
expectancy, urbanized lifestyle, and environmental conditions. (Salinas, Munoz, Sanchez 2020)
For instance, the lifestyle could be influencing the rate of more acute cases of myocardial
infarction. There could exist other factors influencing this higher proportion one of them is the
factor of the first medical contact and the other one is the self-medication in the population.
Furthermore, discuss common medication side effects, as well as possible serious side effects,
and give clients information about how to manage side effects if they occur. Clients will be more
willing to take medications when they have good information about what to expect. Assessments
include monitoring for expected or common effects. For example, teaching drugs can address
signs and symptoms, as well as any additional diagnostic test that will be required. Mortality rate
in hospitals results from an improvement in the clinical management of patients.
| Subject | Nursing | Pages | 4 | Style | APA |
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Answer
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Agreeing or Disagreeing Response
1
I agree with the patient's management protocols in the Intensive Care Unit – ICU and was diagnosed with a heart attack – Myocardial Infarction. Indeed, it is vital for nurses first to examine the heart and the respiratory rate, including checking his medical history before administering Morphine. Notably, the post has correctly mentioned that it is significant to inform the patient of the medication used, administration routes, and side effects. Clinically, the post precisely mentions that lidocaine hydrochloride is intravenously used for acute management of ventricular arrhythmia, with possible side effects like hypotension, swelling, nausea, and vomiting. Moreover, the post accurately mentioned that atenolol was orally administered to reduce heart pressure and cause sleep. Therefore, I am in total agreement with the post.
2
I am entirely in agreement that it is essential to check if a patient has an allergy to chemicals in the drugs that might lead to any adverse effect as a result of administering the prescribed medication. Additionally, I concur that an electrocardiogram analysis should be done for clinical confirmation of Myocardial Infarction. Notably, the post correctly highlighted clinical conditions like COVID-19 that are associated with Myocardial Infarction. Furthermore, I agree with the post for articulating that it is crucial to explain to a patient about all the medication like Atenolol, lidocaine, and aspirin used for, including their functions and side effects. Moreover, the post correctly enunciates that the patient might be willing to take medicine when they are made aware of what to expect. However, I tend to meekly disagree about asking a lot of questions to a patient in the Intensive Care Unit – ICU with Myocardial Infarction. Therefore, I partially agree and disagree with the post.
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References