CASE STUDY: Acute Anterolateral Myocardial Infarction

1. List Patient A’s major risk factors for CHD and discuss other possible risk factors for heart
disease.

2. Discuss the pathophysiology of CHD and the signs and symptoms (i.e., classic physical
exam findings) exhibited by the acutely ill patient during an MI. What are the common
complications post-infarction?

3. What patient history points indicate the diagnosis of MI in Patient A’s case?

4. Correlate the pathology, complications, and nursing care for a patient with MI with the
patent’s progress from the CCU to home.

5. Review the action, side effects, and specific nursing care for the drugs commonly used in the
treatment of patients with MI, including:

o Analgesics (e.g., morphine)
o Sedatives (e.g., phenobarbital)
o Antianxiety medications (e.g., diazepam)
o Anticoagulants (e.g., heparin)
o Laxatives/stool softeners
o Vasopressors (e.g., norepinephrine)
o Vasodilators (e.g., nitroglycerin)
o Diuretics (e.g., furosemide)
o Cardiotonics (e.g., digoxin)
o Cardiac stimulants (e.g., epinephrine, isoproterenol)
o Cardiac depressants (e.g., amiodarone)
o Antilipidemic drugs (e.g., atorvastatin)

6. Describe the treatment for MI.

7. What diagnostic tests usually confirm an MI?

8. Nursing care of the patient with MI is directed toward detecting complications, preventing
further myocardial damage, and promoting comfort, rest, and emotional well-being. Discuss
the specific care needs for each situation listed below:

o On admission to the CCU
o During episodes of chest pain
o Fluid retention
o Rest
o Elimination
o Exercise and immobility
o Psychologic stress
o Patient teaching and discharge panning for a cardiac rehabilitation program

9. Psychologic support is imperative for the well-being of the patient with MI. Discuss the
patient’s potential anxieties and fears and the best means to provide realistic emotional
support and reassurance.

10. Should Patient A make specific lifestyle changes? If so, what changes and how can these be
encouraged?