Question

A patient is admitted to a Coronary Care Unit following a severe myocardial infarction. The patient has swollen oedematous legs leaking copious amounts of exudate which are macerating the patient's skin. The leg is red, hot and inflamed too. Briefly describe nursing care?

Answer 1

It is extremely important that the patient with MI is rapidly diagnosed and treated to preserve cardiac muscle.

Intervention

Initial

• Ensure patent airway.
• Administer oxygen by nasal cannula.
• Obtain 12 kead Ecg
• Insert two intravenous catheters.
• Assess pain using PQRST pneumonic.
• Initiate continious Ecg monitoring and identity underlying rythm.
• Obtain baseline blood work.
• Obtain portable chest X-Ray.
• Assess for antiplatelet, anticoagulation, or fibrinolytic therapy as appropriate.
• Administer Aspirin and B eta adrenergic blockers for cardiac- related chestpain unless contraindicated.
• Administer antidysrhytmic drugs as indicated.
• Assess the sound exudate for consistency, odour and amount
• Chronic heart failure can lead to grossly edematous legs that leak vast amounts of Exudate from the skin.
• Bandaging and leg elevation is beneficial but care must be taken to ensure that the cardiac system is not overloaded by a large quantity if fluid being pushed suddenly from the interstitial spaces of the skin into the circulation.
• Management should be focused around palliative symptoms management such as absorbent dressing s and topicsl antimicrobial s.