peer responses NSG 3300

Reply / add to the following 2 discussion posts. Each response only needs to be 1/2 page.

Discussion 1:
“An MI can result when a prolong total disruption of blood flow to the myocardium causes cellular death by necrosis” (Banasik & Copstead, 2018, P.389). Acute MI result in 125,000 deaths annually in the United States. The risk of having one raises with advanced age. However, men are typically at higher risk than women. (Banasik & Copstead, 2018) An MI can be caused by pieces of plaque breaking off into the arterial blood vessels and clogging the pathways to and in the heart. “High blood levels of cholesterol encourage the formation and growth of vascular plaques and increases the risk of heart attack and stroke” (Harvard Health Publishing, 2019, para 1).
“The diagnosis of MI is based on three primary indicators: signs and symptoms, electrocardiographic changes, and elevations in levels of specific markers proteins in the blood” (Banasik & Copstead, 2018, p.389). The nurse needs to closely monitor the patient’s vital signs keeping a close eye on things such as blood pressure and oxygenation levels, applying oxygen if necessary. When the nurse reviews the patient’s labs, they will notice elevated levels of troponins and CK-MB. It is important to encourage rest at this time. The nurse may need to administer pain medication related to the discomfort the patient may feel in their chest. The Patient may need to be placed on a cardiac monitor to watch for dysrhythmias as well. The goals of medical management are to minimize myocardial damage, preserve myocardial function, and prevent complications.
Patient education will include dietary plans that he should be following. Education on the medications regiment he should be following as well as side effects to expect and who to contact if any adverse effects come up. This patient needs to be educated on the proper diet, like staying away from foods high in fat to prevent further clogging of arteries. Avoid medication and foods that may contraindicate what is currently prescribed. They will also need to be educated on weightlifting restrictions, work restrictions, and when they can resume sexual activity. The patient needs to be educated on staying properly hydrated; educated on the importance of finishing his medications as prescribed; staying active to prevent blood clotting. Education can be achieved through the use of videos or pamphlets preferably at the educational level in which the patient can understand
Interdisciplinary team members will consist of a cardiologist. The cardiologist would diagnose and prescribe pertinent medication and deliver health care instructions. They would also explain any upcoming procedures. Nurses are necessary to monitor patient vital signs, labs, physical well-being, assist with activities of daily living. While the patient is in the hospital, the nurse would also explain any newly prescribed medications, as well as alert the doctor of any life-threatening events and patient concerns. “Food is directly involved in many of the risk factors for coronary heart disease.” (Harvard Health Publishing, 2019) A nutritionist may be a part of the team, to help teach the patient proper eating habits. This is to ensure productive habits to prevent eating foods that may increase the patient’s cholesterol.

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References
Banasik, J. L., & Copstead, L. C. (2018). Pathophysiology (6th ed.). St. Louis, MO: Elsevier.
Harvard Health Publishing. (2019, May 3). Can we reduce vascular plaque buildup?. Retrieved from https://www.health.harvard.edu/heart-health/can-we-reduce-vascular-plaque-buildup#:~:text=Plaque%20forms%20when%20cholesterol%20lodges,a%20cap%20over%20the%20area

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Discussion 2:
1. Myocardial Infarction (MI) is unfortunately more common than people realize. A person may suffer from an MI and show no deficits, another person may suffer from an MI and it can be fatal. Myocardial infarction is a key component of the burden of cardiovascular disease. The assessment of the incidence and case fatality of myocardial infarction are important determinants of the decline in coronary disease mortality (Roger, Véronique L., 2007). Environmental factors include air pollution, and climate change may initiate a MI. In each case of MI, a profound imbalance exists between myocardial oxygen supply and demand (Belleza, Marianne, et al, 2017). This is why air pollution and a change in climate could trigger a MI. Acute myocardial infarction is associated with a 30% mortality rate; about 50% of the deaths occur prior to arrival at the hospital. A lot of people ignore the signs and symptoms they are having, or they may confuse it with heart burn.
2. Three nursing priority nursing interventions include
-Administer oxygen, as needed
-Monitor patient for chest pain and heart rhythm changes
-Encourage bed rest
A few labs to monitor, that are as well critical indicators include Cardiac enzymes and isoenzymes, LDH, Troponins, Myoglobin, WBC, and an ECG (Belleza, Marianne, et al , 2017). Those are a few of the labs and diagnostics for a MI
3. Three areas of patient education include:
-Pharmacological therapy education (ACE Inhibitors, Morphine, Thrombolytics
-Planning time for follow-up appointments and diagnostics
-Teaching the signs and symptoms of an MI. (Chest pain)
Patient education is imperative for every diagnosis. In a myocardial infarction, education can be completed in order to prevent another MI from occurring.
4. Members of an interdisciplinary care team will need to be included in the recovery of a patient recovering from an MI. Members of the team, also known as the acute MI and HF quality work group, consisted of physicians (general cardiologist, heart failure specialist, hospitalist), clinical pharmacists, nurses, cardiac rehabilitation specialists, nutrition specialists, and case managers (Coons, et al., 2007). Hospitals are now required to include at least three separate members from the interdisciplinary care team to meet expectation. I think more than 3 member need to be included. In the case of a myocardial infarction, pharmacist, nursing staff, MD, social services, dietitian and therapy need to be involved
References
Roger, Véronique L. “Epidemiology of Myocardial Infarction.” The Medical Clinics of North America, U.S. National Library of Medicine, July 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC2537993/ (Links to an external site.).
Belleza, Marianne, et al. “Myocardial Infarction: Nursing Management and Study Guide.” Nurseslabs, 26 Sept. 2017, nurseslabs.com/myocardial-infarction/.
Coons, et al. “Multidisciplinary Team for Enhancing Care for Patients with Acute Myocardial Infarction or Heart Failure.” OUP Academic, Oxford University Press, 15 June 2007, academic.oup.com/ajhp/article-abstract/64/12/1274/5134775?redirectedFrom=fulltext.

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