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Case Studies Acute Myocardial Infarction ( Stemi)
Course: Nursing Foundation (NURS 301)
21 Documents
Students shared 21 documents in this course
University: Texas A&M University
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CASE STUDIES
ACUTE MYOCARDIAL INFARCTION (STEMI)
DO NOT READ THE NAME OF THE DISEASE TO THE CLASS. BEGIN READING
PATIENT DATA FROM THE PARAGRAPH BELOW
Mr. M. is a 50-year-old male patient who came in to the emergency department with
complaints of chest pain while mowing his lawn. He is accompanied by his wife, who says that
he was working in the yard and had to call for help because of his discomfort. He complains of
chest pain, rated at a “7” on a 0 to 10 scale and describes it as a feeling of pressure in the center
of his chest. The pain does not radiate to any other location. He has nausea that developed 2
hours ago and he vomited once. Upon exam, he is breathing rapidly and is diaphoretic and he
appears anxious. Mr. M tells the nurse, “I think I am having a heart attack.” The patient has a
history of hyperlipidemia, in which he takes atorvastatin, and hypertension, in which he takes
nifedipine. He does not have a history of angina and has never experienced chest pain; because
of this, he is concerned that he has not had any warning signals prior to this event. He started
smoking cigarettes in high school and smoked about 1 pack per day for 18 years before
successfully quitting.
STOP. ANSWER THE FOLLOWING QUESTIONS
How should the nurse explain the relationship between a patient’s lack of history of angina and
an acute MI? Describe the factors that would determine the severity of this patient’s MI.
1. Angina is a condition marked by serve pain in the chest, and often spreads to the extremities.
Sometimes people have silent heart attacks which is either no symptoms, minimal symptoms, or
unrecognized symptoms.
The severity of an MI depends on the amount of occlusion in the artery, how long the occlusion
has been present, and whether other vessels nearby are also occluded. Some factors increase
the risk of a person having an MI, including a history of hyperlipidemia or diabetes, male
gender, history of hypertension, family history of MI, and tobacco use. The patient in this
example suffers from hyperlipidemia and he is a male; additionally, he has a smoking history
even though he currently does not smoke tobacco.
RESUME READING CASE STUDY
Mr. M has an ECG and has several blood tests to check cardiac enzymes, including creatine
kinase, troponin, and myoglobin levels. The ECG shows an anterior wall ST elevation myocardial
infarction (STEMI).
STOP. ANSWER THE FOLLOWING QUESTIONS
Explain the difference between a STEMI and a NSTEMI and how these two conditions would be
treated. What nursing interventions would the nurse employ first after learning of the
diagnosis of a STEMI? Describe the changes in cardiac enzymes that would most likely
develop because this patient is having an MI. Based on the fact that the patient has a
STEMI as seen on ECG, would the physician wait to find out the cardiac enzyme results before
providing treatment? Why or why not?
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