Nursing care of a patients with acute myocardial infarction receiving the thrombolytic drug (Streptokinase) : case study

Abstract

Abstract

            Introduction : Acute myocardial infarction is a critical condition of the cardio vascular system due to its high mortality rate and potential for serious complications.

            Objective : To study the nursing care of a patient with acute myocardial infarction receiving thrombolytic therapy at Chakkarat Hospital, Nakhon Ratchasima Province.

            Methodology : This is a case study of one patient with acute myocardial infarction who received thrombolytic therapy at Chakkarat Hospital, conducted from January 12 – 13, 2025. Data were collected from the patient’s medical records and assessments based on Gordon’s functional health patterns. The nursing process was used to identify nursing diagnoses during the critical phase, provide appropriate nursing care, and evaluate outcomes.

            Results : The patient was a 66-year-old Thai female with no underlying diseases, no known drug allergies, non-smoker, non-drinker, and no known genetic disorders. Her body mass index (BMI) was 22.51 kg/m². She presented to the hospital with the chief complaint of chest pain and cold sweating, which began 3.5 hours prior. Pain score was 5. EKG show ST elevation at leads II, III, aVF, ST depression at aVL; Troponin I was 9.42 ng/l. Vital signs: temperature 36.7°C, pulse 60 bpm, respiratory rate 20 bpm, blood pressure 130/65 mmHg, and oxygen saturation 99%. Assessment using Gordon’s functional health patterns and clinical symptoms revealed the following nursing problems: Severe chest pain, Risk for impaired tissue perfusion due to decreased cardiac output, Risk of complications from thrombolytic therapy, Anxiety related to the acute illness, Knowledge deficit regarding acute coronary syndrome and self-care and Risk of deterioration during patient transfer The nursing process was applied for initial assessment and timely management of the critical condition, resulting in patient safety.

Keywords : Nursing care, acute myocardial infarction, thrombolytic drug