7 Myocardial Infarction (Heart Attack) Nursing Care Plans

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Myocardial infarction (MI) or acute myocardial infarction (AMI) commonly known as heart attack happens when there is marked reduction or loss of blood flow through one or more of the coronary arteries, resulting in cardiac muscle ischemia and necrosis.

Myocardial infarction is a part of a broader category of disease known as acute coronary syndrome, results from prolonged myocardial ischemia due to reduced blood flow through one of the coronary arteries.

In cardiovascular diseases, the leading cause of death in the United States and western Europe usually results from the cardiac damage or complications of MI. Mortality is high when treatment is delayed and almost one-half of sudden deaths due to an MI occur before hospitalization, within one hour of the onset of symptoms. The prognosis improves if vigorous treatment begins immediately.

Nursing Care Plans

The goals of treatment for myocardial infarction are to relieve chest pain, stabilize heart rhythm, reduce cardiac workload, revascularize the coronary artery, and preserve myocardial tissue.

Here are seven (7) nursing diagnosis for myocardial infarction (heart attack) nursing care plans (NCP):

  1. Acute Pain
  2. Activity Intolerance
  3. Fear/Anxiety
  4. Risk for Decreased Cardiac Output
  5. Risk for Ineffective Tissue Perfusion
  6. Risk for Excess Fluid Volume
  7. Deficient Knowledge
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Activity Intolerance

Nursing Diagnosis

May be related to

  • Imbalance between myocardial oxygen supply and demand
  • Presence of ischemic/necrotic myocardial tissues
  • Cardiac depressant effects of certain drugs (beta-blockers, antiarrhythmics)

Possibly evidenced by

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  • Alterations in heart rate and BP with activity
  • Development of dysrhythmias
  • Changes in skin color/moisture
  • Exertional angina
  • Generalized weakness

Desired Outcomes

  • Demonstrate measurable/progressive increase in tolerance for activity with heart rate/rhythm and BP within patient’s normal limits and skin warm, pink, dry.
  • Report absence of angina with activity.
Nursing Interventions Rationale
Document heart rate and rhythm and changes in BP before, during, and after activity. Correlate with reports of chest pain or shortness of breath. Trends determine patient’s response to activity and may indicate myocardial oxygen deprivation that may require decrease in activity level and/or return to bedrest, changes in medication regimen, or use of supplemental oxygen.
Encourage rest initially. Thereafter, limit activity on basis of pain and/or adverse cardiac response. Provide nonstress diversional activities. Reduces myocardial workload and oxygen consumption, reducing risk of complications.
Instruct patient to avoid increasing abdominal pressure (straining during defecation). Activities that require holding the breath and bearing down (Valsalva maneuver) can result in bradycardia (temporarily reduced cardiac output) and rebound tachycardia with elevated BP.
Explain pattern of graded increase of activity level: getting up to commode or sitting in chair, progressive ambulation, and resting after meals. Progressive activity provides a controlled demand on the heart, increasing strength and preventing overexertion.
Review signs and symptoms reflecting intolerance of present activity level or requiring notification of nurse or physician. Palpitations, pulse irregularities, development of chest pain, or dyspnea may indicate need for changes in exercise regimen or medication.
Refer to cardiac rehabilitation program. Provides continued support and/or additional supervision and participation in recovery and wellness process.
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Other Possible Nursing Care Plans

Here are other nursing diagnoses you can use to make nursing care plans for myocardial infarction:

  1. Activity intolerance —imbalance between myocardial oxygen supply/demand.
  2. Grieving, anticipatory—perceived loss of general well-being, required changes in lifestyle, confronting mortality.
  3. Decisional Conflict (treatment)—multiple/divergent sources of information, perceived threat to value system, support system deficit.
  4. Family Processes, interrupted—situational transition and crisis.
  5. Home Management, impaired—altered ability to perform tasks, inadequate support systems, reluctance to request assistance.

See Also

You may also like the following posts and care plans:

Cardiac Care Plans

Nursing care plans about the different diseases of the cardiovascular system:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

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