In: Nursing
Postoperative NCP for MI and Pneumonia
# MI
Acute pain related to coronary artery occlusion.
- Assess the pain level.
- Provide calm and quiet environment.
- lnstruct the patient to do relaxation techniques .
- Provide medications as per order.
Activity intolerance related to imbalance between myocardial oxygen supply and demand .
-Document the heart rate and rhythm.
- Instruct the patient to avoid vulselva maneuver.
Risk for excess fluid volume .
- Assess for jugular vein distension.
- Measure input and output.weigh daily .
- Provide low sodium diet.
# Pneumonia
Ineffective airway clearance related to inflammation.
- Assess the rate, rhythm and depth of respiration.
- Assess the cough and hydration status.
- Auscultate the lungs .
- Teach the client deep breathing exercises.
Impaired gas exchange related to collection of mucus in airways.
- Assess respiration.
- Observe colour of skin , mucous membrane , and nail beds for noting cyanosis.
- Assess the anxiety level.
- Monitor ABG 's and pulse oxymetry .
- Administer oxygen.
- Elevate head end .
Hyperthermia related to infection.
- Monitor vital signs.
- Monitor input and output chart.
- Give antipyretics