About Nursing of acute myocardial infarction

Acute myocardial infarction is a serious type of coronary heart disease, coronary artery disease in the coronary artery on the basis of a sharp reduction or interruption of blood supply, resulting in the corresponding occurrence of persistent and severe myocardial ischemia, myocardial ischemic necrosis caused by some clinical common on showed severe and persistent chest men Tong (some patients had no pain, often complicated by heart failure, shock and cardiac arrhythmia, sudden cardiac death is the main reason. In recent years, there is an increasing trend in the incidence of acute mortality of acute myocardial infarction high, serious harm to the patient's life, therefore, to observe the condition, early diagnosis, active rescue, effective care is the key to successful treatment. now in our hospital in January 2005 -2008 in December of 18 patients admitted with acute myocardial infarction the treatment of nursing are described below.

1 Clinical data
18 patients, 12 males, 6 females; aged 45-80 years, mean age 58 years, of which due to bleeding, thrombosis wall disease in 8 cases, shock, dehydration or severe arrhythmias to sudden cardiac output reduced disease in 6 cases, overworked disease in 4 cases.

2 nursing
2.1 Psychological care: Most patients with varying degrees of fear and anxiety, so we have to provide patients with a quiet safe, clean, comfortable environment for treatment and care. Ward fresh air, space for harmony and articles neatly placed, coordination, so that patients feel comfortable, relaxed spirit; a sense of personal privacy of patients should pay attention to shielding, to reduce environmental stimulation in patients with malignancy, patients are encouraged to adjust the attitude, confidence, optimism, and positive outlook on life, health care workers to be generous manner, speech, decent, enthusiasm to be patient, as the same family, it feels like a warm family, which can actively cooperate with medical treatment and care, put an end to convey the patient in front of the family, economy, work and other issues, so as to avoid adverse patient stimulation, worse.

2.2 oxygen care: time to pay attention to oxygen, flow, acute phase should be given high flow oxygen, flow 4-6L/min, lasting 1-2 days, after a smooth flow condition can be reduced to a low per minute 2-4L/min continuous flow of oxygen, nasal catheter changed every day, wet bottles of water, to keep things clean and oxygen with a smooth pipe.

2.3 appropriate bed rest: be the first week after the onset of absolute bed rest. No visiting staff, quiet and comfortable environment in patients with grooming, feeding, stood up, and all urine by the nursing staff to assist in daily activities, in order to reduce the patient's physical exertion and cardiac stress. care operations and treatment required to achieve a planned, prepared, to avoid affecting the patient rest the second week of bed to do activities such as washing, eating, etc., such as a stable condition can be the third week of bed to stand, the second will take care of themselves , indoor walking, can be a gradual increase in activity, activity time is not more than 30min. for patients with complications, bed time should be extended.

2.4 Diet and bowel care: should Zhu Huanzhe frequent meals, eating should not be fed, given digestible low-salt, low fat, less gas-producing foods, eat fresh vegetables and fruits. Stable condition to a semi-liquid. Quit smoking wine.

Maintain smooth stool, if necessary, can be used laxatives or enemas to prevent arrhythmias induced during the stool, or even sudden death. In addition, to prevent the occurrence of constipation, patient advocacy to the dangers of constipation and hard bowel movement, to eliminate the tension and fear, defecation in patients not used to the bed to be patient advice, training in the bed and defecation. Links to free download http://www.hi138.com 2.5 pain care: patients frequently occurring suddenly, accompanied by pain, squeezing feeling Therefore nurses need to carefully observe the nature of pain, duration due to severe pain, restlessness and increased myocardial oxygen consumption and cardiac stress, induced heart failure, arrhythmias and shock, so the pain as soon as possible pain, give pethidine or morphine analgesia, while close observation of breathing, looking for changes, to prevent the inhibition of drugs on respiration and circulation. effective analgesic sedative measures can not be ignored.

2.6 closely monitoring early detection of complications
2.6.1 Blood pressure in patients with acute myocardial infarction serious complications can occur at any time, in cardiogenic shock as the main cause of death, timely detection is crucial for the rescue time. Nurses should be every 15 ~ 30min, blood pressure, pulse 1, such as blood pressure, patients appear pale, lips cyanotic limbs Jueleng, irritability, cold sweats and other symptoms, patients can determine a state of shock, active anti-shock treatment .

2.6.2 ECG monitoring of patients with acute myocardial infarction and arrhythmia, occurred in within 24h, with the most common arrhythmia. Check CCU ward 3 to 5 days, continuous ECG monitoring to detect, possibly as ventricular fibrillation Any sign of premature ventricular contractions and ventricular tachycardia or complete atrioventricular block, severe sinus bradycardia, atrioventricular arrhythmia, be corrected. CCU nurses should correctly identify the various arrhythmias graphics, to ensure Continuous ECG monitoring quality, effective control of malignant arrhythmia.

2.7 Rehabilitation nursing: rehabilitation of patients, their concerns are worried about the recurrence of myocardial infarction, discharged after the onset of fear of lack of timely medical treatment and care we need to strengthen health education, so patients and their families understand the disease pathogenesis, treatment, and predisposing factors and self-rescue and other related knowledge, change their eating habits and irrational of successful cases the patient aware of the myocardial infarction can be prevented. so that they always under medical care, enhance patient self-care ability and confidence, encourage patients to establish the optimistic thinking, peace of mind rest, to avoid factors that trigger angina, reduce the patient became agitated and maintain a happy, can reduce the recurrence in good psychological care at the same time, is also necessary to ease the work of family members, between the patients and their families will help to establish a new mental illness rehabilitation environment.

Furthermore, it should encourage patients to bed early activities. Myocardial infarction patients should lift the ideological concerns, not long-term bed rest-term bed rest will not only weaken the force of myocardial contraction, but also stimulate thrombosis caused by the risk of care should be given according to the disease active support and guidance, so that patients have a reasonable amount of exercise, do not be too hasty.

2.8 discharge guidance: will urge patients to rest and avoid fatigue cold and emotional instability, frequent meals, avoid satiation, constipation. Contraindications alcohol and tobacco, due to increase activity in order to not cause fatigue as appropriate, on a regular basis to review patient ECG. Links to free download http://www.hi138.com