7 Myocardial Infarction (Heart Attack) Nursing Care Plans


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

Risk for Excess Fluid Volume

Nursing Diagnosis

Risk factors may include

  • Decreased organ perfusion (renal)
  • Increased sodium/water retention
  • Increased hydrostatic pressure or decreased plasma proteins.

Possibly evidenced by

  • Not applicable. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred and nursing interventions are directed at prevention.

Desired Outcomes

  • Maintain fluid balance as evidenced by BP within patient’s normal limits.
  • Be free of peripheral/venous distension and dependent edema, with lungs clear and weight stable.
Nursing Interventions Rationale
Auscultate breath sounds for presence of crackles. May indicate pulmonary edema secondary to cardiac decompensation.
Note JVD, development of dependent edema. Suggests developing congestive heart failure or fluid volume excess.
Measure I&O, noting decrease in output, concentrated appearance. Calculate fluid balance. Decreased cardiac output results in impaired kidney perfusion, sodium and water retention, and reduced urine output.
Weigh daily. Sudden changes in weight reflect alterations in fluid balance.
Maintain total fluid intake at 2000 mL/24 hr within cardiovascular tolerance. Meets normal adult body fluid requirements, but may require alteration or restriction in presence of cardiac decompensation.
Provide low-sodium diet/beverages. Sodium enhances fluid retention and should therefore be restricted during active MI phase and/or if heart failure is present.
Administer diuretics:  furosemide (Lasix), spironolactone with hydrochlorothiazide (Aldactazide), hydralazine (Apresoline). May be necessary to correct fluid overload. Drug choice is usually dependent on acute or chronic nature of symptoms.
Monitor potassium as indicated. Hypokalemia can limit effectiveness of therapy and can occur with use of potassium-depleting diuretics.

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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