Mathew’s experience is associated with several life-threatening complications of acute myocardial infarction. Mathew’s treatment management of his illness begins with aggressive intervention of doctors, nurses and other allied health professional as time is very critical for patient suffering from myocardial infarction. The closer the treatment is to the onset of AMI, the more optimistic the outcome for the patient American Heart Association (2010).
If the patient first presents with chest pain and is suspected to have AMI, an ECG ( 12 lead- lead ECG) should be perform immediately and reviewed as this will provide a strong evidence of coronary artery blockage due to thrombus formation according to American Heart Association (2010). ECG monitoring of patient cardiac performance must be continuously recorded until an AMI diagnosis has been established (i. e. ST-segment elevation).
Once AMI is established, the administration of fibrinolytic drugs must commence immediately to enhance coronary blood flow and myocardial perfusion (ST-Elevation Myocardial Infarction Guidelines Group and the New Zealand Branch of the Cardiac Society of Australia and New Zealand, 2005). Other initial management treatment given to patient should include the use of oxygen by nasal prongs, sublingual nitrates (systolic arterial pressure < 90 mm hg,HR < 50 or HR. 100 bpm), adequate analgesia ( morphine sulphate or meperidine, aspirin) as stated by the American Heart Association (2010).
Blood tests should be obtained for serum levels of (CK, CK-MB, troponin, myoglobin), FBC, electrolytes, glucose, liver function, renal function, and lipids to assist in diagnosis and consideration of other complications that may exist. Other adjunct therapies such as oxygen, sublingual GTN and morphine (for pain), antiemetic may need to be given in accordance with patient needs (ST-Elevation Myocardial Infarction Guidelines Group and the New Zealand Branch of the Cardiac Society of Australia and New Zealand (2005).
The main goal for Mathew’s AMI management is to limit the size of the infarction, support the heart during shock, relieve the pain, and manage arrhythmias and identifying risks. Other goals include providing education and discharge management plan concerning the diagnosis and necessary lifestyle changes needed to prevent another infarction in the future. Nurses must work hand in hand with the patient to develop realistic management plan that is appropriate for patient understanding and compliance in adhering in his treatment regime.
This includes re-establishment of antihypertensive medications, educating patient in regards to dangers of elevated glucose level and know their signs and symptoms and verbalize interventions for both ; develop a weight management plan and exercise regime. Mathew also needs to be strongly advised of the alternative options to help him stop smoking, adhering to strict diet (low–saturated fat and low cholesterol diet), encourage participation in cardiac rehabilitation program to reduce risks of MI occurrence. He may need to be referred to a councillor in order develop strategies to appropriately manage his stress levels.
Finally, Mathew should be advice the importance of having regular medical check-ups and his dedication in complying with ongoing treatment management regime to prevent further risks of AMI (Yuan, 2004). Conclusions: This assessment has explored and discussed the causes and other risk factors that help contribute to Mathew’s illness. The pathophysiology of coronary artery disease has been discussed and explored. Pharmacological intervention and treatment management plan are highlighted to tackle this heart killing disease.
Time is very important in treating Mathew in order to minimise the adverse impact on his heart and complications that may arise. The skilled collaboration and dedication of nurses, doctors and other allied healthcare professionals and their immediate intervention can make a huge impact on saving Mathew’s life. Most importantly, Mathew’s cooperation in adhering with his treatment regime will give him the best outcome in managing his illness.
REFERENCES
ABC Health and Well Being, (2010). Hyperterension (high blood pressure). Retrieved March 19, 2010 from http://www. abc. net. au/health/library/stories/2006/10/23/1831329. htm