1. The client/caregiver can define myocardial infarction.
   1. A myocardial infarction results from reduced or blocked blood flow through one of the coronary arteries to the myocardial tissue.
   2. This blockage causes the death of the heart tissue.
2. The client/caregiver can list factors that may increase the risk of myocardial infarction but cannot be changed.
   1. Increasing age
   2. Gender (men are at greater risk)
   3. Heredity, which includes individual family history and race
3. The client/caregiver can list major risk factors that can be modified to decrease the risk for heart disease.
   1. Use of tobacco products
   2. High blood cholesterol
   3. High blood pressure
   4. Physical inactivity
   5. Obesity
   6. Diabetes mellitus
   7. Stress
   8. Alcohol abuse
4. The client/caregiver can recognize signs and symptoms of a myocardial infarction.
   1. Chest discomfort or pain is often described as an uncomfortable pressure, crushing or squeezing pain, or substernal pain. Pain usually occurs in the middle of the chest.
   2. Discomfort or pain in one or both arms, back, neck, jaw, or stomach
   3. Shortness of breath
   4. Complaints of nausea, lightheadedness, or sweating
   5. Anxiety or feeling of dread
5. The client/caregiver will know what to do if signs of myocardial infarction occur.
   1. Remain calm and assist the client in a comfortable position.
   2. Call 911.
   3. Follow any previous instructions from a physician regarding medication to be used in this type of emergency.
   4. If the client loses consciousness and no pulse is found, cardiopulmonary resuscitation should begin and continue until trained help arrives.
6. The client/caregiver can list measures to prevent a reoccurrence of myocardial infarction.
   1. Explain the medication treatment plan ordered by a physician. Understanding the medication regimen will promote compliance.
   2. Lose weight if overweight (weight-loss diet guide).
   3. Follow the cardiac disease dietary recommendation of low-fat, low-cholesterol, and low-sodium diet (give related teaching guides).
   4. Encourage the client to participate in a cardiac rehabilitation program.
   5. Understand physical limitations as dictated by the physician and cardiac rehabilitation program. Clarify when and how to resume sexual activity.
   6. Monitor blood pressure and pulse.
   7. Avoid alcohol.
   8. Avoid the use of tobacco products (tobacco-cessation guide).
   9. Learn and use stress-management techniques (stress-management guide).
   10. Learn what symptoms to report to the physician immediately, such as chest pain, shortness of breath, or changes in blood pressure or pulse.
   11. Monitor and report symptoms of depression to a physician.
   12. Use Medic Alert cards or bracelets indicating health history and medications.
7. The client/caregiver is aware of possible complications.
   1. Dysrhythmias
   2. Cardiogenic shock
   3. Arterial or pulmonary embolism
   4. Pericarditis
   5. Mitral insufficiency

Resources

American Heart Association
www.americanheart.org
National Institutes of Health
www.nih.gov
American Red Cross Services—CPR
www.redcross.org/services
American Dietetic Association
www.eatright.org

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com