Plaque within the coronary circulation is displaced, causing activation of the clotting cascade and formation of a thrombus. Thrombus may cause a permeant blockage or breakup before permanent damage occurs.

Assessments: (cardiovascular assessment)

• Auscultate the heart sounds (listen to valve sounds) Pulse

• Skin assessment (cool, clammy skin) Respiratory rate (looking for elevated RR)

• Blood pressure (looking for elevated BP) Temp (core temp increases, peripheral temp decreases)

• ECG (rhythm and ST elevation)

Nursing Interventions:

• Medications (MONA)-- Morphine: analgesic and relaxes smooth muscle/ systemic vasodilation (reducing cardiac demand) and reduces anxiety.

• O2: only if oxygen saturations are below 95% (if above 95% can worsen symptoms)

• Nitro-glycerine (GTN): vasodilation Monitor BP, can cause drop in blood pressure

• Aspirin: antiplatelet, reduces platelet aggregation and further formation of clot.

• Reassurance: reduce stress Sit in semi-fowlers: reduce venous return/ reducing preload, facilitates breathing

• Hydration: loosing fluid through sweat, fast breathing – fluid makes blood less viscous/ f lowing better

Complications: heart failure, death if left untreated.

Nursing care: and MI is considered an emergency situation.

• Administer medications as ordered.

• Administer oxygen if SPO2 below 95%, monitor vitals closely.

• Keep patient calm and decrease anxiety.

• Strict bed rest.

• Education after on lifestyle changes such as diet, exercise, smoking cessation and regular check-ups.