![]() ![]() Low has three risk factors: age 75, obesity, and smoking. Exposed collagen and plaque activate platelets and the coagulation cascade, resulting in thrombus formation. ![]() Atherosclerotic plaque can rupture through the lumen of the artery. As plaque increases, the artery’s lumen narrows, and eventually results in ischemia, which prevents oxygenated blood from reaching the heart muscle, causing chest pain. Other factors that contribute to heart disease risk and that can be modified, treated, or controlledĪtherosclerosis frequently occurs in bifurcated arteries or areas of blood-flow turbulence. Major risk factors that can be modified, treated, or controlled Some myocardial infarction (MI) risk factors can’t be changed, whereas others can. After menopause, the rate of heart disease in women increases and rivals that of men. Pathophysiology and prevalenceĪccording to the Centers for Disease Control and Prevention, coronary heart disease is the leading cause of death in the United States. Every nurse should have a working knowledge of key MI assessments. Patients admitted to the acute care setting are most at risk of death. ST elevation on a 12-lead ECG and positive troponin blood chemistry indicate a medical emergency.Īlthough EDs are the first to receive patients with MI, some may occur after admission. Type 5: MI associated with cardiac surgeryįor the purposes of this review, we’ll focus on Type 1 MI (ST-segment elevation MI ), which is caused by atherosclerotic plaque rupture, ulceration, fissure, or erosion leading to intraluminal thrombus formation and obstructed coronary blood flow. Type 4: MI associated with percutaneous coronary intervention (Type 4a) or stent thrombosis (Type 4b) Type 3: Sudden unexpected cardiac death with symptoms that suggest myocardial ischemia Type 2: MI secondary to ischemia caused by either oxygen demand or decreased supply Type 1: Spontaneous MI related to ischemia caused by a primary coronary event (for example, plaque erosion or rupture, fissuring, or dissection) The five types of myocardial infarction (MI) are: Low’s room to retrieve an antacid to treat indigestion. Low’s chart and finds that he’s been a smoker for 55 years and has a history of heart failure. Low rates his pain as 6 and tells Sam that he had a similar episode the previous week, but that he didn’t go to the ED. Low if this is how he felt in the emergency department (ED) and then asks him to rate his pain on a 1 to 10 scale. Low’s lungs are clear at the apex and diminished in the bases. Low’s blood pressure (BP) is 135/75 mmHG and his heart rate (HR) is 88 beats per minute (bpm). Sam’s focused cardiac assessment indicates that Mr. ![]() Low is diaphoretic and short of breath, his respiratory rate (RR) has increased from 12 (when he was admitted) to 22 breaths per minute, and his O 2 saturation is 95% on room air. ![]() Low sitting up in bed and holding his hand to the center of his chest. The evening nurse, Sam Cordone, finds Mr. After dinner he experiences chest pain and pushes his call button. Henry Low*, age 75, is admitted to a monitored unit with indigestion-related chest pain. Focused chest pain assessment, 12-lead ECG performance, emergent administration of loading medications such as aspirin, and an anti-platelet agent are imperative to the survival of heart muscle and patient lives.Rapid nurse identification of myocardial infarction in medical surgical patients is key to achieving lifesaving treatment in the heart catheterization lab.Author Guidelines and Manuscript Submissionįocused assessment can aid quick diagnosis and treatment.Nursing Times 116: 1, 53-55.Īuthor: Xabi Cathala is lecturer, School of Health and Social Care/Institute of Vocational Learning Calvin Moorley is associate professor for nursing research and diversity in care, School of Health and Social Care/Adult Nursing and Midwifery Studies both at London South Bank University. The ability to perform an A-G assessment is a key nursing skill, as it should be standard practice not only in critically ill or deteriorating patients, but in all patients receiving care.Ĭitation: Cathala X, Moorley C (2020) Performing an A-G patient assessment: a practical step-by-step guide. It is based on the ABCDE approach used when resuscitation may be needed, extended by two additional steps. The A-G method is a systematic and structured approach of assessing patients, useful both in routine and emergency situations. This article provides a step-by-step description of the method The A-G method is a systematic and structured approach to patient assessment useful both in daily nursing practice and emergency situations. ![]()
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