Case Study Of ST Elevation Myocardial Infarction

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Q1: Pt is diagnosed with ST elevation myocardial infarction (STEMI) which normally occurs due to antheroscheloric plaque rupturing and distributing in the blood vessall. Substances that promote platelet aggregation and thrombus formation are then exposed in the blood streams which will eventually cause blockage of blood flow in the coronary artery . Patient’s medical history of hypertension is one of the most important risk factors of acute Myocardial infarction as the constantly high blood pressure can cause damage to artery endothelium and make her more vulnerable in developing atheroschelerosis plaque If the cessation of blood flow will stop oxygen and nutrient supply to heart muscle, the heart muscle becomes injured and eventually myocardial …show more content…
Hence patient’s blood pressure drops. Once hypoperfusion is detected, tachycardia is triggered by stress response as the hypothamalus is stimulated to active adrenal medulla into releasing adrenalin. Adrenalin can increase heart rate in order to increase cardiac output. () Patient’s symptoms of cool extremities, mottled skin, slow capillary refill indicate poor blood circulation, hypoperfusion due to STEMI and peripheral vessel is constricting to centralize blood flow. Nurse should continuously monitor patient’s response to medication and oxygen treatment. Clinical observations, manual blood pressure, vital signs and level of consciousness and cardiac reading should be under continuously monitoring and reassessing to identify clinical changes and make adjustment on treatment accordingly. This is rated as an moderate to highly prioritized nursing strategy.

Another moderate prioritized nursing strategy is to elevate the legs to increase blood pressure and reduce ankle
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It is also used to identify pulmonary oedema. It is a non-invasive, fast, straight-forward diagnostic method to assess current cardiac functioning.
Focusing on Patient Grace’s chest xray result. heart size is determined by the cardiothoracic ratio. If heart size is less than half of the diameter of the chest, it is determined as normal( ). Because of Patient is having STEMI, her heart contractility has decreased at the myocardum zone of ischemiac and necrosis , It is important to determine the normality size of the heart to see if there is any excessive blood or systematic fluid volume in the heart and cause heart to enlarge ().
Pulmonary oedema and vascular congestion are also found on the chest xray.

Myocardial infarction will cause systolic and diastolic dysfunction which makes the heart decrease its ability exchange fluid, pumonary venous pressure will then increase. The capillary hydrostatic pressure causes Pulmonary oedema and pulmonary vascular congestion. Excessive fluid will accumulate in the lung and alveoli which may develop into progressive deterioration of alveolar gas exchange and respiratory failure. In the chest xray, pulmonary oedema is shown as an “ white dense cloudy area”. Pulmonary oedema can impair air exchange at the air sac and cause respiratory

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