Nursing care of patients with acute ST-elevation myocardial infarction and received intravenous thrombolytic drug : Two case study
Abstract
ABSTRACT
An acute ST-elevation myocardial infarction (STEMI) is the leading cause of death in Thailand. It is a crisis that causes a sudden death of a patient due to coronary artery occlusion. Therefore, the patient requires immediate treatment with thrombolytic drug.
Objective : To study the nursing care of patients with acute ST-elevation myocardial infarction and received intravenous thrombolytic drug. Two specific patients studied at the emergency room, Kantharawichai Hospital, Maha Sarakham Province.
Method : This study was a descriptive study. The patient with acute ST-elevation myocardial infarction who received thrombolytic drug involved of this study. Case study in two specific patients admitted to the emergency room at Kantharawichai Hospital by using STEMI Fast Track. All data was conducted between October 1, 2020 and July 31, 2021. The instruments for data collection were composed of interviews, observations, medical records, Gordon’s functional health patterns assessment, nursing diagnosis, and nursing guideline of American Nurse Association.
Results : Both case studies have a clear similarity of signs and symptoms: chest tightness, cold sweat. Both case studies had different health problem perception. The first case study perceived that his condition was severe but the second case study perceived that the illness was mild due to the symptoms similar to his underlying disease symptoms. In term of other complications during treatment, there were different symptoms. For the first case study, ventricular fibrillation was detected and defibrillations and cardio pulmonary resuscitation (CPR) was performed after receiving the drug. The second case study had cardiogenic shock after receiving the medication. Signs of anxiety about their conditions were observed from two cases. Both are similar in smoking behaviors.
Conclusions : From a case study, the nurse role in caring acute myocardial infarction in critical condition is importance to assess and screen patients accurately upon arrival at the hospital in order that the patient is properly diagnosed and treated with thrombolytic drugs. Nurses should be having knowledge with regard to drug administration and surveillance for changes that may occur in patients and nursing operations during referral to a hospital with higher potential. As a result, the mortality rate of patients can be reduced.
Keywords: acute myocardial infarction, thrombolytic drug, nursing care, case study
