Question

Non-ST-elevation myocardial infarction. (Non-ST-elevation myocardial infarction)

What is the the description procedure of NSTEMI?

What are the indications of NSTEMI?

Considerations pre, intra, post?

Client education on NSTEMI?

Potential Complications on NSTEMI?

Nursing interventions?

Answer 1

Non- ST elevation of Myocardial infarction

Description: Non - ST elevation of Myocardial infarction ( NSTEMI) is a type of heart attack. A heart attack is an Acute Myocardial infarction some times fatal caused by the sudden occurance of Coronary Thrombosis which obstructs the blood supply to the heart and leads to necrosis of the heart muscles. NSTEMI is a less damaging heart attack or mild heart attack. The common heart attack that damages the heart is STEMI ( ST elevation Myocardial infarction).

Even though the clinical manifestations are same, During an Electro cardiogram of a Heart attack patient:

*Non STEMI shows T wave inversion, depressed ST wave

* no progression to Q wave

* Coronary artery partial blockage.

But a STEMI shows:

* progression to Q wave

* elevated ST wave

* Coronary artery : fully blocked Coronary arteries.

Indications of NSTEMI:

NSTEMI may experience in the people, who have the risk factors such as:

* Smoking  

* Family history of heart diseases or stroke

* High cholesterol or high blood pressure

* lack of exercise, physical inactivity

* Diabetes , over weight or obese

Considerations : (Pre)

If the patient experiences the the following symptoms of NSTEMI or STEMI , call 911 immediately   : The symptoms are:

* Chest tightness, pressure and discomfort

* Pain in jaw , back , neck and stomach

* Shortness of breath

* light headedness, dizziness

* nausea, sweating

Hospital: ( intra)

NSTEMI can be diagnosed by the procedure ECG : ST wave pattern can detect the presence of heart attack.

Blood test:

Elevated levels of Creatinine kinase myocardial brand , troponin I and T , indicates the presence of Myocardial infarction.

Treatment ( post)

* Drug treatment with Anticoagulants , antiplatelets, ACE inhibitors ( Angiotensin Converting Enzyme Inhibitors), Statins, Nitrates and beta blockers can be used.

Procedures: Coronary artery bypass graft ( C ABG), Percutaneous coronary intervention ( PCI) can be performed in cae of medium risk.

Potential complications :

* Disturbance of rhythm, rate and conduction of heart

* Heart failure

* Ventricular aneurysm

* Pericarditis

* Ruptured papillary muscles

Client education :

* Instruct the patient to limit the intake of trans and saturated fat

* Instruct the patient to quit smoking and eat a well balanced, heart healthy diet with whole grains, fresh fruits and vegetables.

* Educate the patient about the importance of regular physical exercise and relaxation techniques such as deep breathing exercises, meditation etc.

Nursing Interventions:

* Administer oxygen to relieve shortness of breath

* Provide a comfortable position with back rest or semi Fowler 's position to ease the breathing by increasing chest expansion

* Encourage bed rest and changing of position frequently to prevent stagnation of fluids in the lung field

* Monitor vital signs frequently

* Administer medications as per physician's order.