Holistic Assessment and Care Plans
Introduction
Cardiogenic shock is a condition caused by decreased cardiac output due to impaired contractility of the heart. Acute myocardial infarction is the main cause of cardiogenic shock which leads to multiple organ failure (Van Diepen et al., 2017). The patient developed this condition after post coronary angioplasty due to myocardial infarction. Occlusion of the coronary artery which causes the death of myocardial tissue leads to myocardial infarction.
Objectives
The objectives are to increase the patient’s cardiac output and tissue perfusion by decreasing ventricular afterload, lowering oxygen demand, and boosting oxygen delivery to the heart.
Interventions
The patient’s therapies include establishing continuous ECG and hemodynamic monitoring, closely monitoring adverse medication therapy reactions, continually monitoring blood pressure using an intra-arterial line, and recording intake and urine output.
Holistic Assessment
One of the most critical abilities a nurse has in this circumstance is estimating pain. The chest pain was evaluated using the ‘PQRST’ pain evaluation tool. The tool assessed pain’s causative or palliative causes, quality, location or radiation, severity, and time parameters (Toney- Butler & Unison, 2018). Exertion, cold, emotional stress and smoking are elements that trigger ischemia discomfort (Anderson & Morrow, 2017). Medications such as nitroglycerin, which alleviates pain in myocardial infarction, are considered palliative factors. Chest discomfort caused by myocardial infarction has a tightness, pressure, or constricting character. The pain frequently begins in the center or left side of the chest and travels to the shoulder, arm, neck, or jaw. The ten-point scale assigns a severity rating to pain, ranging from 0 (no pain) to 10 as most excruciating. Dyspnoea, nausea, feeling dizzy, a chilly sweat, or fatigue are associated symptoms. Myocardial infarction causes pain that lasts longer than a few minutes.
Care Plan for Formal Diagnosis
Care Plan for Current Symptoms
Reference List
Anderson, J.L. and Morrow, D.A. (2017). Acute myocardial infarction. New England Journal of Medicine, 376(21), pp. 2053-2064.
Toney-Butler, T.J., and Unison-Pace, W.J. (2018). Nursing admission assessment and examination.
Van Diepen, S., Katz, J.N., Albert, N.M., Henry, T.D., Jacobs, A.K., Kapur, N.K., Kilic, A., Menon, V., Ohman, E.M., Sweitzer, N.K. and Thiele, H., 2017. Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association. Circulation, 136(16), pp.e232-e268.
Tehrani, B.N., Truesdell, A.G., Psotka, M.A., Rosner, C., Singh, R., Sinha, S.S., Damluji, A.A. and Batchelor, W.B., 2020. A standardized and comprehensive approach to the management of cardiogenic shock. JACC: Heart Failure, 8(11), pp. 879-891.
Roth, S., Fox, H., Fuchs, U., Schulz, U., Costard-Jäckle, A., Gummert, J.F., Horstkotte, D., Oldenburg, O. and Bitter, T., 2018. Noninvasive pulse contour analysis for determination of cardiac output in patients with chronic heart failure. Clinical Research in Cardiology, 107(5), pp. 395-404.