Question

Mr. John is a 55-year-old male, who presents to the A & E department at 4:00 pm with a history of shortness of breath, diaphoresis, severe left-sided chest pains, rating 10/10 on the pain scale, for the past three hours.

Mr. John is a known hypertensive and diabetic patient, who is non-compliant with his medications. He is also overweight. He smokes a pack of cigarettes every day for the past fifteen years. The patient notes that he was admitted to hospital one year ago and was treated for angina pectoris and his father died of an MI at age 65. He is married and is a father of four children.

On admission his vital signs were T 37.9, P 112, R- 32, BP- 156/108, blood glucose- 346mg/dl. He had a physical assessment and various test done and a diagnosis of Acute Myocardial Infarction was made.

identify three nursing diagnosis for this patient?

Answer 1

Acute Myocardial Infraction

An Acute Myocardial infarction is caused by the sudden occurrence of Coronary Thrombosis , which obstructs the blood supply to the heart and leads to necrosis of heart muscle tissue .

Three nursing Diagnosis for the patient Mr. John, who is suffering with Myocardial Infraction:

1. Acute pain related to tissue Ischemia as evidenced by reports of chest pain and a pain scale reading of 10/ 10.

( expected outcome: patient will verbalize the relief from chest pain, within appropriate time frame)

2. Ineffective breathing pattern related to the Myocaridal infarction/ insufficiency of heart to pump blood adadequately as evidenced by shortness of breath.

( Expected outcome: Patient maintains an effective breathing pattern as evidenced by relaxed breathing at a normal rate.)

3. Activity intolerance related to imbalance between myocardial oxygen supply and demand as evidenced by increase in heart rate and BP with the activity.

( Expected outcome: Demonstrate an increase in tolerance for activity with pulse and BP within normal limits).

Other possible Nursing diagnosis:

* Fear and anxiety related to threat of death as evidenced by increased tension and restlessness.

* Risk for decreased cardiac output related to changes in rate and rhythm of heart rate.

* Deficient knowledge related to misunderstanding of therapy needs/ medical condition as evidenced by failure to improve on previous regimen ( as he is still continuing in obesity, smoking etc).