ASSESSMENT EXPLANATION OF THE OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

PROBLEM

SUBJECTIVE:“Suma Myocardial infarction, >After 8 hours of Dx> Obtain full Pain is a subjective Goal met, patient
sakit ang dibdib ko” commonly known as nursing description of pain experience and has verbalized
a heart attack, occurs intervention the from patient must be described relief/control of
•Restlessness when the blood patient will including location, by patient chest pain within
•Facial grimace supply to part of the Verbalize intensity (0–10), appropriate time
•Pain scale of 9 out heart is interrupted relief/control of duration, frame for
of 10 causing some heart chest pain within characteristics administered
•V/S taken as cells to die. This is appropriate time (dull/crushing), and medications.
followsT: 37.6 ˚CP: most commonly due frame for radiation. Assist
112R: 12BP: 140/ to occlusion administered patient to quantify
100 (blockage) of a medications pain by comparing
coronary artery it to other
A> Pain r/t following the rupture experiences
coronary of Decreases external
artery a vulnerable atheroscl Tx> Provide quiet stimuli, which may
occlusion erotic plaque, which is environment, calm aggravate anxiety
an unstable collection activities, and and cardiac strain,
of lipids (like comfort measures limit coping
cholesterol) and white abilities and
blood cells (especially adjustment to
macrophages) in the current situation
wall of an artery. The
resulting ischemia >Assist in Helpful in
(restriction in blood relaxation decreasing
supply) and oxygen techniques, e.g., perception of/
shortage, if left deep/slow response to pain.
untreated for a breathing, Provides a sense of
sufficient period of distraction having some
time, it can cause behaviors, control over the
damage and/or death visualization, situation, increase
(infarction) of heart guided imagery in positive attitude.
muscle tissue
(myocardium). Increases amount
>Administer of oxygen available
supplemental for myocardial
oxygen by means uptake and
of nasal cannula or thereby may
face mask, as relieve discomfort
indicated associated with
 tissue ischemia

> Administer
medications as
indicated:

•Antianginals, e.g., Nitrates are useful

nitroglycerin, for pain control by
isosorbide dinitrate coronary
(Isordil) vasodilating
effects, which
increase coronary
blood flow and
myocardial
•Beta-blockers, perfusion.
e.g., atenolol
(Tenormin), Important second-
propranolol line agents for pain
(Inderal), control through
metoprolol effect of blocking
(Lopressor) sympathetic
stimulation,
thereby reducing
heart rate, systolic
BP, and myocardial
oxygen demand

•Analgesics, e.g., Although

morphine, intravenous (IV)
meperidine morphine is the
(Demerol) usual drug of
choice, other
injectable narcotics
may be used in
acute-
phase/recurrent
chest pain
unrelieved by
nitroglycerin to
reduce severe
pain, provide
Edx>Instruct sedation, and
patient to report decrease
pain immediately. myocardial
workload

Delay in reporting
pain hinders pain
relief/may require
increased dosage
of medication to
achieve relief