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Patient Education: MI Crystal, Jaron, Troy, Dani

Disease Process
Acute coronary syndrome, results from
reduced blood flow through one or more
coronary arteries, which causes myocardial
ischemia and necrosis Myocardial
infarction (MI) results when myocardial
tissue starts to die because of absent or
diminished blood su!!ly "hen heart tissue is
de!ri#ed of o$ygenated blood su!!ly for a
!eriod of time and an area of tissue in the
heart begins to die
A blood #essel su!!lying the heart muscle is
suddenly bloc%ed The heart muscle su!!lied
by this blood #essel is called the myocardium
The !art of the heart muscle su!!lied by this
artery loses its blood &and o$ygen' su!!ly if
the #essel is bloc%ed This !art of the heart
muscle is at ris% of dying unless the bloc%age
is (uic%ly remo#ed "hen the heart muscle is
damaged it is said to be infarcted The term
myocardial infarction means damaged heart
muscle
Past Medical )istory*Predis!osing +actors
, Aging
, Diabetes Mellitus
, Ele#ated serum triglyceride, low-
density li!o!rotein, and cholesterol
le#els, and decreased serum high-
density li!o!rotein le#els
, E$cessi#e inta%e of saturated fats,
carbohydrates, or salt
, )y!ertension
, .besity
, /edentary lifestyle
, /mo%ing
, /tress or a ty!e a !ersonality
&aggressi#e, com!etiti#e attitude,
addiction to wor%, chronic
im!atience'
0oals*.b1ecti#es:
, The !atient will #erbali2e the
im!ortance of balancing acti#ities as
tolerated with ade(uate rest !eriods
, 3The !atient will #erbali2e
understanding of each medication,
dosage and !ur!ose
, The !atient will e$!ress recognition of
his acute condition and acce!t the
lifestyle changes he needs to ma%e
Diet and Acti#ity-4ifestyle changes
Encourage the !atient to !artici!ate in
a cardiac rehabilitation e$ercise
!rogram
5uild u! your le#el of acti#ity
and e$ercise gradually
A reasonable goal by about si$
wee%s after ha#ing an MI is to
aim to wal% for 67-87 minutes
each day
/tress the need to sto! smo%ing If
necessary, refer the !atient to a
su!!ort grou!
9e#iew dietary restrictions with the
!atient If he must follow a low-
sodium, low-fat, or low-cholesterol
diet, !ro#ide a list of foods to a#oid
Eat at least five portions of a
variety of fruit and
vegetables each day They
are rich in #itamins and
minerals These can be fresh,
fro2en or dried
Limit the amount of
saturated fat you eat It is not
1ust about the total fat content
of the diet, but also the type of
fat in the diet Try to a#oid
eating foods that are high in
saturated fat +oods that are
high in saturated fat include
meat !ies, sausages, butter,
cream, hard cheese, ca%es,
biscuits and foods that contain
coconut or !alm oil Eating
foods that are high in
unsaturated fat can hel! to
reduce your cholesterol le#el
+oods high in unsaturated fat
include oily fish &such as
herring, mac%erel, sardine,
salmon', a#ocados, nuts and
seeds, sunflower, ra!eseed
and oli#e oil
Reduce you salt intake less
than 2000mg Many foods
contain hidden salt 4owering
your salt inta%e can reduce
your ris% of another MI and
also other cardio#ascular
diseases
Counsel the !atient to resume se$ual
acti#ity !rogressi#ely )e may need to
ta%e nitroglycerin before se$ual
intercourse to !re#ent chest !ain from
the increased acti#ity
.besity
Diabetes, )y!ertension, coronary
artery disease, and stro%es can all
come from being o#erweight which
lead to heart !roblems
Diabetes
More li%ely to ha#e MI because
diabetes damages arteries causing
them to harden causing
atherosclerosis which can cause
hy!ertension which then leads to
heart failure
)y!ertension
A condition, which the force of blood
against your artery walls is high
enough and causes damage to the
#essels resulting in increased
wor%load on heart
/elf-Care )ome Management
Preform MA"D/ teaching and gi#e
out educational co!y
o 9efer to MA"D/
o htt!s:**intermountainhealthcare
org*e$t*Dcmnt:8+ncid
:8D;<7=<>?@
Daily weights, 5P, and heart rate-
record in a daily log
/et a goal for an e$ercise !rogram
o /tart slow - 87 minutes more
than ; times a wee%
/%in Assessment
o Daily
o Edema
o In1uries that wonAt heal
Patient assessment tool B refer to
bottom of the !a!er
.besity
Cse website a#ailable to calculate 5MI
htt!:**wwwnhlbinihgo#*health*educati
onal*loseDwt*5MI*bmicalchtm
E<@; Cnderweight /light ris%
<@; B 6?F Ideal Gormal
6; B 6FF .#erweight Moderate
87 B 8FF .bese )igh
?7H Iery .bese Iery )igh
Diet
o Cholesterol %ee! E677,
)D4 J?7, 4D4 E<77,
Triglycerides E<;7
.besity Article
htt!:**www!atientcou%*health*obesity
-and-o#erweight-in-adults
Daily fasting +/5/
AC*)/
0oal B <77-<?7
<-6 hrs after meal B 4ess than <@7
Diabetes
)emoglobin A<C less than >
Pro!er fitting shoes with daily foot
care
)TG-0oal 5P
<<7-<87*@7-F7 mm)g
Call to schedule follow-u! a!!t with Dr
/omebody in 6 wee%s
Dr !hone K ;;;-;;;-;;;;
*Explain the need to treat recurrent chest
pain or discomfort with sublingual
nitroglycerin every 5 minutes for three doses.
If the pain persists for 20 minutes, teach the
pt to see medical attention. If the pt has
severe pain or becomes short of breath with
chest pain, teach the pt to tae nitroglycerin
and see medical attention right away.
Instruct pt to eep the nitroglycerin bottle
sealed and away from heat.
Call !hysician or call F<< ifL
Pain, !ressure, tightness, or
hea#iness in your chest, arm, nec%, or
1aw
/hortness of breath
0as !ains or indigestion
Gumbness in your arms
/weaty, or if you lose color
4ightheaded
"eight gain 6 or more lbs in a day or
; lbs abo#e target weight
Confusion
Changes in angina
If !atient has any concerns consult
with your Dr
Ad#ise the !atient to re!ort ty!ical or
aty!ical chest !ain Post Myocardial
Infarction (MI) syndrome may
de#elo!, !roducing chest !ain that
must be differentiated from a recurrent
MI, !ulmonary infarction, and heart
failure
Medication osage!Route "hat it does #dverse Effects!
$onsiderations
Mocor 67 mg !o daily 4owers high
cholesterol*triglycerides
Tell a doctor if you
de#elo! une$!lained
muscle !ain,
tenderness or
wea%ness
Do not eat gra!efruit
To!rorol N4 ;7 mg !o daily 9educe force and rate of
)eart
Angina, )TG
4ightheaded
May dull /*/ of
hy!otension
4isino!ril ; mg !o daily 9ela$es #essels - reduces
strain on heart
4ower 5P
Persistent dry cough
Interact with G/AID/,
diuretics
+e/.? 86; mg !o
daily
Ele#ates the serum iron
concentration which then
hel!s to form )igh or tra!!ed
in the reticuloendothelia cells
for storage and e#entually
con#ersion to a usable form
of iron
Iomiting
Abdominal !ain
Consti!ation
Dehydration
Cyanosis
)y!er#entilation
MI
Irregular heartbeat,
dys!nea, swellingof
hands and feet
Prilosec 67 mg !o daily Decreases the amount of acid
!roduced in the stomach
+e#er
/tuffy nose, snee2ing
/tomach !ain
)eadache
Ta%e before eating
Do not crush
Call if you ha#e hi#es,
difficulty breathing,
swelling of fact, li!s
or tongue
/ee% emergency
medical attention if
you ha#e chest !ain
or hea#y feeling, !ain
s!reading to the arm
or shoulder, nausea,
sweating, and
general ill feeling
0lyburide
&diabeta'
; mg !o daily 4owers blood glucose acutely
by stimulating the release of
insulin from the !ancreas
Mild nausea O
heartburn
Joint or muscle !ain
5lurred #ision
Mild itching or s%in
rash
)y!oglycemia
9e!ort s*s of
infection, easy
bleeding or bruising,
yellowing eyes, dar%
urine, sudden weight
gain, mental status
changes, swelling of
hands or feet,
sei2ures
0luco!hage ;77 mg !o
daily
Decreases he!atic glucose
!roduction, decreases
intestinal absor!tion of
glucose, and im!ro#es insulin
sensiti#ity by increasing
!eri!heral glucose u!ta%e
and utili2ation
Diarrhea
Gausea*Iomitiing
0as
)eadache
/ee% medical
attention is sym!toms
of lactic acidosis
which includes musle
!ain, numbness,
troubled breathing,
di22y, slow or une#en
heart rate
/welling or ra!id
weight gain
Chills
GT033 ? mg
sublingual $8
Acute relief of an angina
attac% or acute !ro!hyla$is of
angina !ectoris due to
coronary artery disease
9ela$ation of #ascular
smooth muscle, which causes
dilation of arterial and #enous
beds
)eadache
Iertigo
"ea%nes
Pal!itation
.rthostatic
hy!otension
Tachycardia
/ynco!e
+lushing
9ash
Treat recurrent chest
!ain or discomfort
with sublingual
nitroglycerin e#ery ;
minutes for three
doses If !ain !ersists
for 67 minutes, see%
medical attention
Patient educational assessment tool-/cale <-?
< I donAt %now 6 I %now a little 8 I %now a good amount ? I %now a lot
< "hat is your understanding of your !ast medical conditions and how they relate
to myocardial infarctionsP
6 Do you understand why you are being !rescribed your current medicationsP
8 "hat are !ossible side effectsP
? Are you in com!liance with your current medicationsP
; Do you understand why it is im!ortant to stay on themP
= Do you %now when to re!ort changes to your Doctor or call F<<P
> "hat is your goal blood !ressureP
@ "hat are healthy diet changes that you can ma%eP
F )ow often do you need to e$ercise to decrease chance of MIP
<7 "hat is the significance of your 5MIP