Question

At a local health fair a man approaches the booth and tells the nurse that he is having chest pain and is afraid that he is having a heart attack (myocardial infarction). What actions should be taken? What questions could the nurse ask him to verify if this might be what he is experiencing? What are the differences between angina and a myocardial infarction? What signs and symptoms should be anticipated related to a myocardial infarction? What treatment is used if the patient is suffering from a myocardial infarction?

Answer 1

1.First reassure the client and give him a comfortable position

2.Assess vital signs. Look for sweating and palpitations.Give Oxygen supplementation if needed.Do an electrocardiogram test to rule out Myocardial infarction if available.

3.The nurse should ask about the nature,origin,characteristics of pain, whether its a crushing pain,radiating to left shoulder/arm,aggravting factors,breathing difficulty,previous history MI,Coronary artery diseases etc

4.Angina pain mostly due to atherosclerosis,it radiates to arm/shoulder,pain intensity mild to moderate, exercise/activity precipitate pain,pain will be relived by rest and nitroglycerin,Nausea and vomiting is not common

5.Myocardial infarction is due to complete loss of blood and oxygen to cardiac muscle,no precipitating factor,pain will be severe,not relieved by rest or nitroglycerin,nausea and vomiting is usually associated with pain

6.Symptoms-Pain in chest,back,Left shoulder,dizziness,vomiting,lightheadedness,sweating,palpitation etc ECG changes,Troponin I & T levels and Creatinin Kinase MB levels are increased

7.Management

Oxygen therapy

Complete bed rest/immobilise

Thrombolytic therapy-Inj Streptokinase