B. Create your concept map of the disorder. Use a separate paper for this.

Use short coupon bond and draw your concept map

using this format.

Risk Factors Potential Complications

 Cigarette smoking
 Dysrhythmias
 Passive smoking
 Cardiogenic shock
( second handsmoke)
Sign and Symptoms  Heart failure
 Elevated serum
 Pulmonary edema
cholesterol level  Chest pain that radiate to the  Cool and pale skin  Pulmonary embolism
 Hypertension neck, jaw, shoulder, or left arm.  Nausea or dizziness  Pericarditis
 Impaired glucose  Dyspnea  Diaphoresis
tolerance  Dressler’s Syndrome
 Heart rate & Respiratory faster  Tachycardia
 Obesity
than normal  Tachypnea
 Stress
 Unexplained anxiety, weakness  Shortness of breath
 Physical inactivity or fatigue
 Indigestion
 Palpitations

Disease Process ______________________

Pathophysiology (Definition/etiology chronicity and prognosis)
 Myocardial infarction commonly known as heart attack happens when there is marked reduction or loss of blood flow through one or more of the coronary
arteries.
 In an MI, plaque rupture and subsequent thrombus formation results in complete occlusion of the artery, leading to ischemia and necrosis of the
myocardium supplied by that artery. Vasospasm (sudden constriction or narrowing) of a coronary artery, decreased oxygen supply (e.g., from acute blood
loss, anemia, or low blood pressure), and increased demand for oxygen (e.g. , from a rapid heart rate, thyrotoxicosis, or ingestion of cocaine) are other
cause of MI. In each case, a profound imbalance exists between myocardial oxygen supply and demand.

 Approximately every 43 seconds, an American will have an MI (Mozaffarin et al., 2016) and many of these people will die as a result. Early recognition and
treatment of patients presenting with an MI will improve their chances of survival.

Laboratory Tests, Diagnostic Tests and Medical Interventions Nursing Diagnosis Nursing Intervention
 Ineffective cardiac tissue  Administer oxygen and
perfusion related to thrombus in thrombolytics as ordered.
Medical Interventions coronary artery, resulting in
Laboratory Tests : Begin routine medical interventions: altered blood flow to myocardial
 Troponin
tissue.
 Creatine Kinase and Its  Supplemental oxygen
Isoenzymes  Nitroglycerin  Administer morphine as ordered
 Acute pain related to
 Myoglobin  Morphine and provide care in a calm,
myocardial ischemia resulting
 Aspirin from coronary artery occlusion efficient manner that reassures
 Beta-blocker with loss or restriction of blood the clients and minimizes
Diagnostic Tests :
 Angiotension – converting enzymes flow to an area of the anxiety. Stay with the client
 12 – lead ECG until discomfort is relieved.
inhibitor within 36 hours myocardium and necrosis of the
 Echocardiogram  Anticoagulation with heparin and platelet myocardium.
 MRI inhibitors
 Statin  Risk for decreased cardiac
output related to left ventricular  Administer antidysrhythmic
Evaluate for indications for reperfusion failure. drugs as indicated.
therapy:

 Percutaneous coronary intervention

 Thrombolytic (fibrinolytic) therapy)
I. BIOGRAPHICAL DATA

Name: N/A Age: 50 years old Sex: Male

Civil Status: Address: N/A
Birthday: N/A Birthplace: N/A
Religion: N/A Race or Ethnic Background: N/A
Nationality: N/A Educational level: N/A Occupation: N/A
Who lives with the client: N/A Attending physician: N/A

Date of Admission: August 2, 2020 Sources of Data

Time of Admission: 8: 00 am Primary source: N/A
Room / ward: Medical Ward Secondary source: N/A

II. Chief Complaint

Chest pain and numbness of the left shoulder

III. Admitting Impression

Myocardial Infarction

IV. History of Present Illness

2 hours prior to admission, upon waking up in the morning 6am, the patient was seen taking his morning coffee. An
hour prior to admission, patient experienced chest pain with numbness at the left shoulder, blood pressure was taken and revealed
a result of 150/90 mmHg and they decided to brought to patient in hospital to seek consultation accompanied by his folks.

V. Past Health History

Patient was been diagnosed with hypertension.

VI. Socio- cultural

Patient is 50 years old, he is known smoker since he was 20 years old, coffee drinker and occasional drinker of
alcoholic drinks.

VII. Substances and medication

Patient takes Metoprolol 50 mg 1 tablet once a day as maintenance for hypertension and he also smoke cigarette, drink
coffee and alcoholic drinks.

Physical Assessment (Cephalocaudal)

General Health and Appearance

Vital Signs: Temp: 37.2°c BP: 160/100 mmhg PR: 96 bpm RR: 26 cpm O2 sat: 94%
Height: N/A Weight: N/A
Speech: N/A
Language: N/A
Mental Status: Oriented with time, place, and person
Emotional Status: Calm but in pain as evidenced by facial grimace.
Posture: Uneven should
Gait: N/A
Personal Hygiene: N/A

Physical Assessment (Cephalo-Caudal Approach)

BODY PARTS INSPECTION PALPATION PERCUSSION AUCULTATION

 Uniform except to some part  Cool & clammy skin

exposed to sun.
Skin  Pale appearance N/A N/A
 No edema, abrasion, lesion.
 Skin unblemishes
 Diaphoretic

 Evenly distributed  No masses

Hair and Scalp N/A N/A
 Thick hair
 No infestation or infection

Normocephalic
Smooth and symmetrical facial
Skull and Face contour and movements  No masses N/A N/A
No edema
Fissures are equal in size
-Symmetric Nasolabial Folds.

 Auricles are symmetrical and  The texture, the auricles

has the same color with his are mobile, firm and not
facial skin. tender. N/A N/A
Ears  The auricles are aligned with the  Pinna recoils after being
folded
outer canthus of eye.
 Contains hair follicles

 Eyebrows: Hair is evenly

distributed,eyebrows  No masses and cysts
symmetrically aligned and found.
showed equal movement. N/A N/A
Eyes  Eyelashes: Appeared to be
equally distributed and curled
slightly outward.
 Eyelids: No presence of
discharges, no discoloration and
lids close symmetrically with
involuntary blinks
 Eyes: sclera appeared white,
conjunctiva appeared shiny,
smooth and pink. Cornea is
transparent and shiny and the
details of the iris are visible.
 There was no presence of
discharge or flaring  No tenderness
 Symmetric and straight
Nose and Sinuses  No discharge N/A N/A
 No lesions.

 The neck muscles are equal in  No lymph nodes

size. palpitated.
Neck  The thyroid gland is not visible N/A N/A
 on inspection.

 Pale moist, symmetric lips

 Gums are darken in color N/A N/A N/A
Mouth  Discoloration of enamels

 Breasts even within the chest wall  Axilla: No tenderness,

 Skin uniform in color masses, or nodules N/A N/A
Breast and Axilla

 Skin is intact  No masses and tenderness Crackles on the broncho vesicular

 Chest walls is intact breath sounds / above the chest
Chest and Thorax N/A wall.
 Exaggerated spinal curves
(Dextroscoliosis)

 
 The abdomen has unblemished  No masses and tenderness  Tympany over the Audible bowel sounds
skin and is uniform in color. stomach and gas-
 The abdomen has a symmetric filled bowels;
Abdomen contour. dullness, especially
over the liver and
spleen.

Genetalia N/A N/A N/A N/A

Upper:
Extremities  Bluish fingernail  No masses
 Delayed Capillary refill
 Cold and clammy skin N/A N/A
 Diaphoresis
 Convex curvature; angle of nail
plate about 160O
 No abrasion
 No lesion & edema

Lower:
 Bluish toenail  No masses
 Delayed Capillary refill  Joint movement
 Cold and clammy skin
 No abrasion
 No lesion & edema
 Intact convex curvature of teonail

Laboratory Tests and Diagnostic Exams

CHEST X-RAY

Dextroscoloisis
Cardiac muscles demonstrate markedly enlarged silhouette
Significance: Enlargement of the cardiac muscles silhouette indicate myocardial infarction or ischaemia. This occurs when narrowed arteries,
caused by fatty deposits that build up in the arteries makes the cardiac muscle to pump blood harder causing cardiac muscle enlargement.

ECG 12 Lead

Significant ST segment elevation

Significance: ST segment elevation can signify myocardial infarction or ischaemia. The injured myocardial cells depolarize normally but
repolarize more rapidly than normal cells, causing ST segment to rise.

LABORATORY RESULTS
Examination Result Normal Value Interpretation Significance
CBC Hemoglobin - 13 Hemoglobin: Low A low level of hemoglobin in the blood relates directly to a low level of
g/dl 13.8 -17.2 g/dL oxygen. Patient has anemia.
Male:
WBC - 8,000 Normal
WBC: 4,500-11,000
cells/mm3 Normal
cells/mm3
FBS 90 mg/dL <100mg/dL Normal Normal
Troponin I 2.0 ng/mL <0.6 ng/mL High A high level of Troponin 1 in the blood can signify heart attack.
Cholesterol 220 mg/dL <200mg/dL High A high level of cholesterol in blood may reflect arteriosclerosis as a cause for
coronary narrowing or spasm.
HDL 60 mg/dL 30-70mg/dL Normal Normal
LDL 170 mg/dL <130mg/dL High A high level of LDL in blood may reflect arteriosclerosis as a cause for
coronary narrowing or spasm.
Triglycerides 160 mg/dL <150mg/dL High A high level of triglycerides in blood may reflect arteriosclerosis as a cause for
coronary narrowing or spasm.
Sodium (Na+) 150 mEq/L 135-145 mEq/dL High A high level of sodium indicate fluid deficits and can results from decreased
water intake or loss of water though excessive sweating.
Potassium (K+) 4 mEq/L 3.5 -5.0 mEq/L Normal Normal