Enferm Intensiva (Engl Ed). 2021 Oct-Dec;32(4):230-237. doi: 10.1016/j.enfie.2021.06.002. Epub 2021 Nov 08.
Mixed shock in patients with acute myocardial infarction: Nursing interventions.
Enfermeria intensiva
S Martínez Font, G López Domènech, S Juan Esgleas, C Ruiz Falqués, M Soler Selva
Affiliations
Affiliations
- Unidad de Cuidados Intensivos Cirugía Cardiovascular, Hospital Clínic, Barcelona, Spain. Electronic address: [email protected].
- Unidad de Cuidados Intensivos Cirugía Cardiovascular, Hospital Clínic, Barcelona, Spain.
- Urgencias, Centro Atención Primaria Blanes 2, Blanes, Girona, Spain.
- Unidad de Cuidados Intensivos Curas Cardiacas Agudas, Hospital Clínic, Barcelona, Spain.
PMID: 34764074
DOI: 10.1016/j.enfie.2021.06.002
Abstract
INTRODUCTION AND OBJECTIVES: We present a clinical case of a 40-year-old woman diagnosed with acute myocardial infarction (AMI) in Killip I who was admitted to our hospital. She experienced complications in the haemodynamic lab and in the operating room, including cardiogenic and anaphylactic shock requiring ventricular assist support. Conservative management support with inotropes and vasopressors in cardiogenic shock has been shown to be insufficient in many patients to maintain adequate perfusion and prevent irreversible multiple organ dysfunction syndrome. For this reason, short-term mechanical circulatory support systems are increasing substantially. The objective of this article is to develop optimal and individualised care plans using the NANDA, NOC, NIC taxonomies.
CLINICAL OBSERVATION: An evaluation based on Virginia Henderson's basic needs was made, and two altered needs stood out: breathing and circulation. The patient required mechanical ventilation and mechanical circulatory support.
INTERVENTIONS: In relation to the highlighted needs, six diagnoses were prioritized according to the NANDA taxonomy using the Análisis de Resultado del Estado Actual (AREA) (Outcome-Present State Test (OPT)) model: risk of decreased cardiac output, impaired spontaneous ventilation, impaired tissue integrity, risk of disuse syndrome, risk of infection and risk of hypothermia.
DISCUSSION AND CONCLUSIONS: Outcome criteria scores showed a favourable evolution after 96 h. The development of a standardized NANDA-NOC-NIC language allowed us to organize the nursing care plan.
Copyright © 2021 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier España, S.L.U. All rights reserved.
Keywords: Anafilaxia; Anaphylaxis; Cardiogenic shock; Cardiorespiratory arrest; Cuidados intensivos; Intensive care unit; Parada cardiorrespiratoria; Shock cardiogénico
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