Heart disease is the most common cause of death in people aged 30 to 70 years.
Myocardial infarction is a violation of the blood supply to the heart, resulting in necrosis of its tissues. The organ can no longer work the way it used to, which leads to the occurrence of concomitant diseases.
The area of tissue damage depends on how quickly and professionally first aid was provided. Learn all about the rules for helping patients from nurses with a heart attack and a nursing process.
What results should the nurse
achieve? Most cases of death in myocardial infarction occur in the firstseveral hours after the diagnosis of .In this period of time, literally, the life and health of the patient is in the hands of a nurse.
To reduce risks, it is necessary:
- to help a patient cope with growing panic and stress( the more the patient worries, the more destructive the consequences will be);
- use analgesics and beta-blockers( in the absence of contraindications);
- if it is impossible to stop pain with nitroglycerin, give the patient stronger drugs( they can be combined with sedatives);
- when using the ST segment on the ECG, use thrombolysis and anticoagulants;
- if necessary, give anesthesia( oxygen with nitrous oxide).
Emergency care before the arrival of the doctor
To reduce the risks for the patient with myocardial infarction and also to stabilize his condition, the actions of the nurse should be as follows:
- Try to calm the patient, not to let him succumb to panic.
- Measure blood pressure, count the number of heart beats a minute.
- Give an assessment of cardiac rhythm readings.
- Provide the patient with a stable and comfortable position of the body( sitting or lying down).It is desirable that all uncomfortable and cramped clothing be removed, as well as fresh air into the room.
- To the extent possible, contribute to the elimination of pain symptoms( as a rule, apply Morphine, Promedol, Droperidol and other drugs).In addition, the water tongue gives validol or nitroglycerin.
- Warm the patient: put the heating pad in the legs, and put mustard plasters on the chest.
- Constantly observe the rhythm of the heart and blood pressure.
- If the condition of a person with a heart attack worsens, it is necessary to carry out resuscitation before the arrival of an ambulance: an indirect massage of the heart and mouth-to-mouth breathing.
To reduce the degree of complications in heart attack, the following drugs are used:
- heparin( to slow the onset of blood clots injected 6-10 units intravenously);
- nitrates( improve blood flow, which slows down and prevents tissue necrosis);
- fibrinolytics( increase the lumen of the veins and allow to avoid necrosis of the myocardium. It is contraindicated for internal hemorrhages, bleeding disorders and oncological diseases).
Care during the period of in-patient rehabilitation
During the period of in-patient rehabilitation, the complex of measures for the care of a patient who underwent myocardial infarction includes:
- Control of compliance with bed rest at least for 2-3 days. If the patient is lying down for more than a week, then prophylaxis and treatment of decubitus should be done daily.
- Permanent heart activity monitoring .The most important indicators are the pulse rate, respiratory rate and blood pressure values.
- Follow and take part in the preparation of a properly selected diet .Food should be frequent, but in small portions, approximately, 100-150 grams of food for one reception. It should be easily assimilated, and also not overload the intestines.
- Compliance with hygiene regulations .All procedures, including bathing, washing, as well as urination and defecation should be strictly in prone position. If the patient has not had a bowel movement for more than 2 days, then laxatives can be used.
- Performing the massage .Any excessive physical activity during the period of in-patient rehabilitation is contraindicated. But in order to more or less maintain muscle tone, you must regularly massage the limbs of the patient( special attention should be paid to the feet), and also give the patient some time( no more than 15 minutes per day) to be held in a sitting position.
Interventions in an outpatient setting
After discharge from a medical facility, the rehabilitation period does not end with the patient. In order for the heart to function in the right rhythm, it is necessary:
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To advise the patient about the need to follow a specific diet of .Usually, it is appointed by the attending physician. The patient must abandon the large amount of consumed cholesterol, trans fats and harmful food additives.
If the food is not balanced, and, in most, includes fatty, spicy and smoked food, the risk of complications and the occurrence of a secondary infarction increases several times.
- Tell about the benefits of physical activity .The patient can study independently, or attend special classes. Without physiotherapy, recovery from a heart attack will be very slow and inadequate.
- Conduct a preventive conversation about the dangers of alcohol and smoking .Before the patient should try to convey that both these bad habits must be completely excluded from his life.
- Sanatorium treatment of .To support the body, you can send a patient for a while to a sanatorium or dispensary, specializing in people who have had myocardial infarction. In such institutions, there is a full range of measures recommended by such a patient.
In addition to all of the above, the patient needs to tell about the schedule of mandatory examinations, and also timely observation by the attending physician.
Possible problems and ways to solve them
The most common problems of patients who underwent myocardial infarction include the following:
Compliance with bed rest. Solution:
- follow the patient's daily routine;
- should be provided with prescribed vitamins and preparations;
- to monitor hemodynamic parameters;
- strictly comply with all prescriptions of the doctor;
- does not omit the patient's initiative.
Tachycardia. Solution:
- to monitor compliance with bed rest for patients;
- follow the directions of your doctor.
Pain in the sternum. Solution:
- give painkillers( as agreed with your doctor);
- put a yellow card on the chest;
- ensure the supply of fresh air to the room where the patient is.
Panic and fear for your life. Solution:
- call a physician;
- to fix the parameters of the ECG;
- enter pain medications( as agreed with your doctor);
- should be sent to the intensive care unit( if necessary).
Acute congestive heart failure. Solution:
- call a physician;
- give the patient oxygen;
- provide the necessary medication.
The person will get better soon if he knows that cares about him, they show sympathy and consult on any issues that concern him.
