Holistic Care of Acute Myocardial Infarction Patient

This document discusses the holistic care of acute myocardial infarction (AMI) patients, including care plans, nursing assessments, nursing diagnoses, and patient education. It covers topics such as cardiac output, dietary considerations, patient age, family history assessment, physical assessment, mental status assessment, nursing diagnoses, and post-discharge education. Find study material and solved assignments on Desklib.

Running Head: MEDICAL SURGICAL 1
Violet Paterson
HOLISTIC CARE OF ACUTE MYOCARDIAL INFARCTION PATIENT
Student’s Name
Professor’s Name
Institution of Affiliation
Date

MEDICAL SURGICAL 2
Introduction
Acute myocardial infarction is the medicinal term for a heart attack, which occurs when
the flow of blood to the heart muscles is gruffly clogged (McKee, & Ronan-Bentle, 2019). Blood
flow cut off leads to destruction on the tissue resulting in cardiovascular disease. Coronary
arteries are responsible for supplying heart muscles with blood, and in case one or more of them
is clogged, it leads to heart attack. Clogging develops due to the accumulation of plaque,
substances that probably contain fat, cholesterol, as well as cellular waste materials.
Task 1. Care plan for Acute Myocardial Infarction (AMI) patient
The following are the factor to consider while preparing a care plan for Miss Violet Paterson
admitted for AMI:
The cardiac output
Cardiac output refers to the volume of the blood the heart pumps per unit time, measured
by finding the product of stroke volume and heart rate. Heart rate is the number of heart beats per
minute while stroke volume is the volume of blood pumped by heart ventricle with each beat (Li,
& Liu, 2018).
Consider other health problem the patient has apart from AMI.
The patient has many health problems like primary hypertension and longstanding
osteoarthritis according to her health history. The additional health problems may be the cause of
the current state of AMI, like primary hypertension which is also a cardiovascular disorder.
Knowledge of existing health problem will assist in preparation for appropriate medication
selection (White et al., 2018).

MEDICAL SURGICAL 3
Patient Dietary
The patient has a health problem of dietary related diseases, starting from AMI which
mainly develops when the diet is full of fat and cholesterol, which further blocks coronary
arteries of the heart. Also, primary hypertension is also a controlled dietary disease, where the
patient is supposed to avoid salt consumption, fast made foods, meat and many other.
The patient should subject to healthy diet bearing fruits and vegetable especially now that
her blood pressure as increased. Further, Osteoarthritis is a bone weakening, and brittle disorder
mostly occurs in women at old age due to the reduction of production of estrogen hormone after
menopause. So, the patient needs a diet full of calcium to strengthen bones (Hardin, & Kaplow,
2019).
Age of the patient
Patient age is important as it helps to determine the kind of drugs to prescribe to her.
Also, the kind of approach the nurse will use and language to use will communicate.
Task 2. Nursing assessments
Nursing assessment entails the collection of information concerning the patient’s entire life in
general. The three assessment priorities are:
Family history assessment
Successful nursing depends on the ability to access the family history of the patient.
Family history will help the nurse to know whether the health problem genetically acquired or it
may be due to other lifestyle issues. The nurse can best handle the patient once the root cause

MEDICAL SURGICAL 4
identified. However, the nurse must employ a therapeutic and professional style of
communication before interviewing the patient (Sharma, Gautam, & Mishra, 2019).
In this case, Miss Violet lives alone in an apartment with her cat Molly and has no
extended family. Therefore, there is a need for the nurse to find out why the patient does not
have extended family and on top, why live in apartments at that old age alone. Knowledge about
her family history will assist in discovering the cause of problems like hypertension that is
triggered by stress.
Family history information assists in deciding future care for the patient after discharge.
Miss Violet is old, and her current health problem is impacting on her ability to meet her daily
living needs, showing that she needs support from a close person, after discharge. Nurses are at a
good position to plan for this care after discharge, once they know the kind of support available
for the patient.
Physical assessment
Miss violet need a regular physical examination to determine cardiovascular condition,
blood pressure, and joint pain or osteoarthritis. The cardiac output should be examined after
every 30 minutes to check whether it is at the expected value. Regular monitoring of patient
blood pressure is crucial, so that nurse can make regulation where necessary. Still, Osteocare
service since the patient is suffering from osteoarthritis where the joint is paining. The nurse will
ensure that the patient works around for some minutes each day to observe the area she will
complain of having pain (Hansen, & Sampognaro, 2019).
Mental status assessment

MEDICAL SURGICAL 5
The nurse here examines the mood, anxiety, illusions, depression, coherence, insight and
hallucinations. In addition to the communication pattern, walking appropriately, hygiene, and
ability to recall thing. Mental status information is vital as it helps to recognize another effect of
illness to patient mind that may interfere with the healing process. AMI can also result from an
unhealthy mental status, and in case the health practitioners fail to access and realize this prior,
treatment can be harder. Most patients suffering AMI appears distracted, ill and confused on pain
(Huffman, 2019).
Task 3. Nursing Diagnoses
Entails clinical judgment by the nurses based on the assessment of the patient and for this case
diagnoses are:
Stress feet fractures
Miss Violet has been having arthritic pain over the last few months before admission to
hospital. The apartment where the patient lives lack the lift to go up to the 3rd floor. The patient
uses now stairs to go at the 3rd flow which continues to strain her body joints especially the feet
as she climbs upstairs. Therefore, she is at the risk of developing bone fractures or cracks, this
because bones of women above menopause are so week and prone to brittle in case of repeated
bone stress (Chou et al. 2019).
Abnormal heart rhythms
The patient has two affecting cardiac disorders that are AMI and increasing blood
pressure. The strain between heart pumping blood to a blocked artery as well as at high pressure
can lead to abnormal heart rhythms. The advanced complications of these conditions can result
in a heart attack or even fatal case (Davis, & Maness, 2019).

MEDICAL SURGICAL 6
Dementia
Interruption of blood flow to the brain limits the volume of blood that is supposed to
reach the brain, resulting in a stroke that causes dementia. The person with dementia is unable to
communicate effectively, and the rate of thinking is low (Kandula, Karthika, & Abraham, 2019).
Patient post-discharge education
The following are the areas of health education to miss violet Paterson for effective post-
discharge life:
Dietary counseling
Diet education is the most vital information that she needs to be well informed. This
because the disorders she has are results of poor dietary. The patient needs to know the healthy
diet plan to follow, whereby the nurse will provide a manuscript containing the kind of food to
consume and the once to avoid. Health education exposes the patient on things that she was not
aware of. Medication only without proper diet consumptions cannot bring the required healing
(Mitchell et al., 2016).
Psychological education
The patient should be prepared psychologically on what can happen later or concerning
her health condition healing process to eradicate anxiety in her. A psychologically prepared
patient can endure body change that she experiences as during medication. Also, she needs to be
informed about post-discharge follow-up by the nurses so that she cannot have fear concerning
further help at home. The nurse should listen to all the fears of the patient and address them
accordingly (Budiman, Snodgrass, & Komatsu Chang, 2016).

MEDICAL SURGICAL 7
Exercise
Although the patient is very old and has some health problems, nurses should encourage
the performance of the exercise. The patient should get educated on simple exercises she can do
that are not straining but simple and helpful to the body of the patient.
High blood pressure management education
The patient case shows that over a few months her blood pressure has been increasing.
Nurses should offer education to the patient on how to manage the blood pressure. Blood
pressure control is a simple disorder that every informed patient can be able to manage only by
following the advice from the health practitioners. The lifestyle of the patient determines the
condition of the blood pressure and the emergence of many other lifestyle diseases like diabetes.
Stress control education
Stress is the main trigger of several diseases and disorders in people living one of them
being high blood pressure, AMI, diabetes, depression and several other. It is true that we cannot
avoid stress in life, but we can learn to control stress to prevent the further effect. The nurse
should educate the patient on how to deal with stressing matters at home place. Some of the
stress managing practices include doing once hobby like watching, playing and any other kind of
hobby one has. The patient should be encouraged to consider hobby work as a stress managing
tool. Also, if a hobby fails to help, encourage the patient to seek guidance and counseling when
she is faced with stress, especially medical counselors (Hermann et al., 2018).
Patient education on adherence to medication procedures prescribed by the doctor

MEDICAL SURGICAL 8
The patient needs to get an education on how to take drugs she has receives for a post-
discharge and a specific time to take. Also, what she can do in case the drug brings about
complication while at home. Most of the patient when affected negatively by drugs, they
disposed them and find help in other health institution instead of reporting the case to the
previous institution. This is bad since the other institution can end up giving the same drugs. So,
the nurse should educate the patient before discharge, the right procedure to follow when the
drugs worsen the condition (Brooks-Carthon et al., 2016).
Team care
Allied health entails a large team of health professionals who utilize scientific principles
and proof based practice for the examination and treatment of acute and chronic diseases;
enhance disease prevention and wellbeing for optimum health (Zusman, 2017). The Allied health
team needed for patient’s care during admission and in preparation for discharge are:
Osteopaths professional
Osteopaths deals with osteopathy or simply the bones where they accentuate more on
physical alterations, as well as another physical handling of muscles tissue and bones. The
patient has osteoarthritis pains, and the osteopaths will be responsible for her treatment (Stone, &
Alter, 2018).
Dietitian
Also, called nutritionist and they deal with diet and proper feeding routine. They
determine the best diet for the patient and ensure that the patient feed on healthy diet depending
on the health status. The patient needs the help of a dietitian, especially when at home place after
discharge from the hospital.

MEDICAL SURGICAL 9
Physical therapist
A physical therapist is a movement specialist dealing with normalizing the quality of life
via accepted exercise, patient education, and hands-on care. Physical therapist access every
person and prepare a plan, utilizing treatment technique to enhance the capability to move,
minimize joint pain, recover functioning of the body, and hinder disability. They also educate the
patient on how to avoid and manage their situation to attain long lasting health benefits.
Cardiovascular technologist
There are three divisions of specialist that is a cardiac sonographer, vascular technologist
and electrocardiograph technicians. Cardiovascular sonographer deals with the examination of
heart valves, vessels and chambers using ultrasound instrumentation to develop images known as
echocardiograms.
Vascular technologist works together with the physician and assists in the diagnosis of
abnormalities interfering with the circulation of blood. They do a noninvasive method utilizing
ultrasound instrumentation to collect data based on blood pressure, oxygen saturation, blood
flow, cerebral circulation, and changes in limp volume. Electrocardiograph technicians deal with
taking and recording electrocardiograms. All mentioned Allied health professionals are crucial
for restoring good health status of the patient and should be considered accordingly (Hasnain,
Gandhi, & Rangaswamy, 2017).
In conclusion, every health practitioner should make sure that the clinical reasoning cycle
followed when delivering health services. Clinical reasoning cycle ensures that patient cases are
handled well with proper procedures and excellent care guaranteed to all patient without
discrimination.

MEDICAL SURGICAL 10
References
Brooks-Carthon, J. M., Lasater, K. B., Rearden, J., Holland, S., & Sloane, D. M. (2016). Unmet
nursing care linked to rehospitalizations among older black AMI patients: a cross-
sectional study of US hospitals. Medical care, 54(5), 457.
Budiman, T., Snodgrass, K., & Komatsu Chang, A. (2016). Evaluation of pharmacist medication
education and post-discharge follow-up in reducing readmissions in patients with ST-
segment elevation myocardial infarction (STEMI). Annals of Pharmacotherapy, 50(2),
118-124.
Chou, Y. S., Lin, H. Y., Weng, Y. M., Goh, Z. N. L., Chien, C. Y., Fan, H. J., ... & Seak, C. K.
(2019). Step-down units are cost-effective alternatives to coronary care units with non-
inferior outcomes in the management of ST-elevation myocardial infarction patients after
successful primary percutaneous coronary intervention. Internal and emergency
medicine, 1-8.
Davis, L. L., & Maness, J. J. (2019). Nurse Practitioner Knowledge of Symptoms of Acute
Coronary Syndrome. The Journal for Nurse Practitioners, 15(1), e9-e12.
Hansen, A. B., & Sampognaro, F. (2019). What patients want to learn after an AMI. Self-
perceived learning needs of patients following an acute myocardial infarction–a literature
review.
Hardin, S. R., & Kaplow, R. (Eds.). (2019). Cardiac surgery essentials for critical care nursing.
Jones & Bartlett Publishers.

MEDICAL SURGICAL 11
Hasnain, M., Gandhi, A. D., Gandhi, A., & Rangaswamy, P. (2017). South Asian Americans: A
Demographic and Socioeconomic Profile. In Health of South Asians in the United States
(pp. 3-21). CRC Press.
Hermann, M., Witassek, F., Erne, P., Rickli, H., & Radovanovic, D. (2019). Impact of cardiac
rehabilitation referral on one-year outcome after discharge of patients with acute
myocardial infarction. European journal of preventive cardiology, 26(2), 138-144.
Huffman, K. C. (2019). The Effects of a Targeted History Question on Patient-Triage Nurse
Communication. Nursing Clinics, 54(1), 33-51.
Kandula, M., Karthika, P., & Abraham, R. (2019). Nurses Action towards Cardio Vascular
Emergencies. Asian Journal of Nursing Education and Research, 9(1), 121-126.
Li, M., & Liu, H. (2018). Implementation of a clinical nursing pathway for percutaneous
coronary intervention: A prospective study. Geriatric Nursing, 39(5), 593-596.
McKee, C. H., & Ronan-Bentle, S. (2019). What Is the Utility of Clinical Scoring Systems for
the Diagnosis/Prognosis of Mesenteric Ischemia?. In Gastrointestinal Emergencies (pp.
101-102). Springer, Cham.
Mitchell, S. E., Martin, J., Holmes, S., van Deusen Lukas, C., Cancino, R., Paasche-Orlow,
M., ... & Jack, B. (2016). How hospitals reengineer their discharge processes to reduce
readmissions. Journal for healthcare quality: official publication of the National
Association for Healthcare Quality, 38(2), 116.

MEDICAL SURGICAL 12
Sharma, P., Gautam, D. K., & Mishra, P. K. (2019). Assessment of Cases of Myocardial
Infarction-A Clinical Study. Journal of Advanced Medical and Dental Sciences Research,
7(2).
Stone, J. A., & Alter, D. A. (2018). The Health Economics of Myocardial Infarction: Black
Boxes and Black Holes. Canadian Journal of Cardiology, 34(10), 1253-1255.
White, K., Macfarlane, H., Hoffmann, B., Sirvas-Brown, H., Hines, K., Rolley, J. X., & Graham,
S. (2018). Consensus statement of standards for interventional cardiovascular nursing
practice. Heart, Lung and Circulation, 27(5), 535-551.
Zusman, A. (2017). Changing degrees: Creation and growth of new kinds of professional
doctorates. The Journal of Higher Education, 88(1), 33-61.