Cardiac Diseases

Policy:

Sudden chest pain caused by the blockage of one of the coronary arteries, usually due to a blood clot, leading to deprivation of blood supply to a portion of the heart muscle, resulting in its death.

Steps:

1.  Take the patient’s medical history to confirm their condition and identify the location of the pain.

2.  Calm the patient and place them in a semi-sitting position.

3.  Connect the patient to a monitor for continuous observation and administer oxygen.

4.  Perform an electrocardiogram (ECG) and present the results to the doctor.

5.  Insert 1-2 peripheral cannulas and take a blood sample for a complete lab workup, including cardiac enzymes (Troponin, LDH, CPK).

6.  Administer medications as prescribed by the doctor (e.g., painkillers, Tridil, Nitroglycerin, Streptokinase, etc.).

Nursing Observation When Administering Streptokinase:

1.  Monitor the patient’s blood pressure and pulse, and observe for complaints such as shortness of breath, vomiting, excessive sweating, or itching. These may indicate an allergic reaction. In this case, stop the streptokinase administration and administer a large dose of hydrocortisone.

2.  The antidote for streptokinase is Cyclokapron, which should be given in case of bleeding.

3.  Perform an electrocardiogram (ECG) on the patient before, during, and after the administration of streptokinase.

4.  Do not administer intramuscular or subcutaneous injections to the patient during or immediately after the administration of streptokinase.

5.  Monitor for signs of bleeding from the nose or mouth.

Important Notes that Nursing Staff Must Follow:

-   Continuously assess pain using a pain assessment scale.

-   Evaluate and record a complete description of the pain.

-   Provide complete rest for the patient to reduce oxygen consumption.

-   Perform an electrocardiogram (ECG) during pain episodes.

-   Administer oxygen if the patient experiences shortness of breath and inform the doctor.