THE CHALLENGE OF NURSING CARE FOR PATIENTS WITH ACUTE MYOCARDIAL INFARCTION, SAMCHAI HOSPITAL, KALASIN: 2 CASE STUDIES

Abstract

Acute myocardial infarction is the leading cause of death in Thailand. Treatment in the community hospitals can reduce the loss of life for the patient in remote service area. Thrombolytic agent as Streptokinase has high risk complication. Nursing care for patient has necessary to more competencies. This study was a descriptive study to compare the prognosis treatment and nursing compose the differences of the patients with acute myocardial infarction 2 patients in Samchai hospital, Kalasin province.

Case Study 1: Thai male 74 years old gave a story of 1 hour before coming to the hospital with having tight chest. ECG test found ST–segment elevation at Lead II, III, aVF. Physician diagnosed as inferior wall myocardial infarction. Patients received anticoagulant medicine as Streptokinase. 15 minute later, the patient loss of consciousness and changed ECG found Ventricular tachycardia. Doctors performed pulse returned to normal by cardioversion 100 joules. The patient received nursing care from problem list and successful reperfusion before referred to Khonkaen hospital.

Case Study 2: Thai female 75 year old gave a story of 4 hours before coming to the hospital with chest pain. Blood pressure 72/46 mm.Hg. ECG test found ST–segment elevation at Lead V2-V4. Physician’s diagnosis is ST segment elevation myocardial infraction with cardiogenic shock. The patient received inotropes drug before receive Streptokinase. Then refer to Khonkaen hospital. The patient has deterioration on the way. She gets loose of consciousness and cardiac arrest. Team staff started advance cardiac life support for 30 minutes. Finally unsuccessful for resuscitation.