Acute MI: analysing health status and setting immediate priorities

This article uses a case study approach to demonstrate how awareness of recent research findings and a sound understanding of pathophysiology enable the nurse to become an effective practitioner. A scenario is described in which the nurse is faced with a man admitted to the coronary care unit with a diagnosis of suspected acute myocardial infarction (AMI). Through analysis of the patient's health status, with frequent reference to pathophysiology, the nurse can perform an accurate nursing assessment and so determine immediate priorities for nursing care. The priority objectives were identified as pain control, management of cardiogenic shock, reperfusion of the myocardium, cardiac monitoring for complications of AMI and the effects of treatment, and management of anxiety. Research-based rationales are provided for all objectives.