Drug Name Dosage, Route, Mechanism of Action Indication and Side and Adverse Effects Nursing Considerations and

Frequency Contraindication Responsibility

Aspirin 80mg Decreases platelet Indication: CNS: Drowsiness, Take the drug with food and full glass
Tablet aggregation Thromboembolitic dizziness, confusion, of water
Class: Once a day disorders, Post MI, headache, flushing
Antiplatelet Oral Prophylaxis of MI, Monitor blood indices (APTT) and CBC
AMI CV: tachycardia,
pulmonary edema Report any signs and symptoms of
Contraindication: toxicity, visual changes, allergic
Allergy to NSAIDs, GI: Nausea and vomiting, reactions and bleeding
salicylates GI bleed, heartburn,
diarrhea, GI ulcers

EENT: tinitus

ENDO: hypoglycemia,
hyponatremia,
hypokalemia

HEMA:
Thrombocytopenia,
agranulocytosis,
leukopenia, increased PTT,
PT bleeding time

INTEG: Rash, urticaria,

bruising
Drug Name Dosage, Route, Mechanism of Action Indication and Side and Adverse Effects Nursing Considerations and
Frequency Contraindication Responsibility

Heparin 14.5 uggts/min Inactivates factor Xa Indication: CNS: Fever, confusion Mix well when adding heparin to IV
Solution for inhibiting thrombus and Unstable angina, AMI, GI: Nausea infusion
Class: injection clot formation CAD HEMA: Hemorrhage from
Anticoagulant Through IV drip any site, hypochromic Do not add heparin to infusion lines
Contraindication: anemia, other than the drug; do not piggyback
Hypersensitivity thrombocytopenia, other drugs into heparin line
bleeding
Provide safety measures to prevent
INTEG: Ecchymosis, inj site injury from bleeding
hematoma
META: Hyperkalemia in check for signs of bleeding
renal failure

Monitor APTT
MS: Osteoporosis
SYST: Edema, peripheral
edema
Drug Name Dosage, Route, Mechanism of Action Indication and Side and Adverse Effects Nursing Considerations and
Frequency Contraindication Responsibility

Captopril 50mg Selectively suppresses Indication: CV: Hypotension, Do not take with food
Tablet renin- angiotensin- For lowering of blood tachycardia, angina
Class Twice a day aldosterone system; pressure Watch out for sudden decrease in
GI: loss of taste, increased
ACE inhibitor Oral inhibits ACE; prevents blood pressure, syncope
Contraindication: liver function tests
conversion of
hypersensitivity Consult physician if lightheadedness
angiotensin I to
GU: Impotence, dysuria,
angiotensin II or dizziness occur
nocturia, proteinuria,
nephrotic syndrome,
Caution patient to report any sign of
acute reversible renal
diaphoresis, vomiting, diarrhea; may
failure, polyuria, oliguria,
lead to hypotension
frequency

INTEG: Rash, pruritus

MISC: Angioedema,
hyperkalemia

RESP: Bronchospasm,
dyspnea, cough
Drug Name Dosage, Route, Mechanism of Action Indication and Side and Adverse Effects Nursing Considerations and
Frequency Contraindication Responsibility

Rosuvastatin 20mg Inhibits HMG-CoA that Indication: CNS: Headache, dizziness, Administer drug at bedtime
Tablet catalyzes the first step hypercholesterolemia insomnia, hypertonia
Class Once a day in a cholesterol Provide comfort measures in dealing
Antihyperlipi- Oral synthesis pathway, Contraindication: CV: hypertension, with headache, cramps, nausea etc
demic resulting in a decrease Allergy vasodilation, angina
in serum cholesterol pectoris, palpitation

GI: Nausea, dyspepsia,

diarrhea, constipation,
liver failure

RESP: Pharyngitis, rhinitis

Drug Name Dosage, Route, Mechanism of Action Indication and Side and Adverse Effects Nursing Considerations and
Frequency Contraindication Responsibility

Metoprolol 50 mg Blocks beta adrenergic Indication: CNS: Insomnia, mental Asses weight, skin condition,
Tablet receptors, decreasing Hypertension, acute changes, diziness, head neurologic status, pulse, pulse rate,
Class every 12 hours SNS thus lowering BP MI ache blood pressure, ECG and respiratory
Beta-blocker Oral status
Contraindication CV: heart failure,
Hypersensitivity arrhythmia, cardiac arrest Give with food to facilitate absorption

GI: gastric pain, flatulence Report difficulty in breathing, night

constipation, diarrhea,
nausea, vomiting
RESP: Bronchospasm,
dyspnea, wheezinf
cough, swelling of extremities, slow
pulse, confusion, depression, rash,
fever, sore throat
 Drug Name Dosage, Route, Mechanism of Action Indication and Side and Adverse Effects Nursing Considerations and
Frequency Contraindication Responsibility

Morphine 2 mg Agonist at specific Indication: CNS: Monitor vital signs

solution for opioid receptors in the Pain following MI Light headedness,
Class: injection CNS to produce dizziness, sedation Assess skin color, texture, lesions,
Opioid As needed analgesia Contraindication orientation, reflexes, bilateral grip,
Analgesic through IV Hypersensitivity DERM: Laryngospasm, strength, affect , pulse, blood
bronchospasm pressure, perfusion, adventitious
sound, normal
GI: Nausea and vomiting Monitor for signs of toxicity. WOF
respiratory distress
MAJOR HAZARDS:
Respiratory depression, Keep resuscitation, tracheostomy sets
apnea, circulatory and naloxone ready
depression, respiration
arrest, shock, cardiac
arrest

Drug Study
Assessment Diagnosis Planning Intervention Rationale Evaluation
Subjective Acute Pain Short term: Independent Independent: Goal Met
P: Masakit ung related to Patient will 1. Instructed the client to notify 1. Delay in reporting pain
dibdib nag simula decreased demonstrate nurse immediately when chest hinders pain relief/ may
sa likod pati mga myocardial decreased pain with pain occurs necessitate increased
balikat kahit wala blood flow in 15 minutes. dosage of medication to
naman akong secondary to achieve relief
ginagawa acute Long Term: 2. Monitored and documented 2. Clients with acute MI
myocardial After 8 hours of characteristics of pain, verbal appear ill, distracted and
Q: Parang infarction nursing intervention and non verbal cues, and focused on pain. Verbal
pinipiga and health teaching hemodynamic responses history and deeper
patient will remain investigation should be
R: Dito sa may free from pain postponed until pain is
dibdib ko hangang relieved.
sa mga balikat ko 3. Provided quiet environment, 3. Decreases external stimuli,
calm activities and comfort which may aggravate
S: VAS: 5/10 measures anxiety and cardiac strain
4. Assisted and instructed patient 4. Helpful in decreasing
T: matagal kasi in relaxation techniques perception of/response to
kahit nagpapahinga pain.
ako, 5. Check vital signs before and 5. hypotension and
nararamdaman ko after administration of narcotic respiratory depression can
medication occur as a result of narcotic
administration
Objective: 6. Checked skin temperature and 6. Determines adequate tissue
Chest discomfort peripheral pulses frequently perfusion
Cold, clammy 7. Assisted in position changes and 7. To decrease energy toll on
extremities maintain bed rest patient
Diaphoresis
Facial Grimace Collaborative: Collaborative:
PR: 110bpm 1. Administer supplemental oxygen 1. May relieve discomfort
BP: 140/90 by face mask at 5Lpm as associated with myocardial
RR: 25 breaths per indicated uptake
minute 2. Administer medications as 2.
O2 Sat: 94% indicated
1. ASA ASA possess qualities that
assist in stabilizetion of
plaque.
2. ISDN Nitrates increases bloodd
flow and perfusion.
3. Metoprolol Beta blockers are second
line agents for pain by
blocking SNS.
4. Morphine Morphine reduces severe
painand decreases
myocardial workload
Risk factors include: Risk for Short term: Independent: Independent: Goal met
Changes in rate in decreased After 4 hours of 1. Maintained bed rest during 1. Decreases oxygen
rhythm cardiac output nursing acute episode consumption and demand,
HR: 110bpm intervention, client reducing workload
HR: 120bpm will report
HR: 73bpm decreased episode 2. Auscultate BP, comparing both 2. hypertension may occur
BP:140/80 of angina and arms and obtain lying, sitting related to ventricle
full bounding pulse dyspnea and standing pressures when dysfunction
occasional dyspnea able.
Chest pain Long Term: 3. Evaluate quality and equality of 3. decrease cardiac output
Infarcted muscle After 8 hours of pulse, as indicated results in diminished
Fatigue and weakness nursing thready pulses
intervention, client 4. Auscultate heart sounds 4. S4 may be associated with
will be myocardial ischemia
hemodynamic
stability 5. Auscultate breath sounds 5. Crackles reflecting
pulmonary congestion may
develop because of
depressed myocardial
function
 6. Note response to activity and
promote rest adequately
7. Provided small and easily
digestible meals
6. Overexcertion increases
oxygen consumption
7. large meals may increase
myocardial workload and
cause vagal simulation

Collaborative:
1. Administered supplemental
oxygen as indicated
2. Maintained IV access as
indicated
3. Reviewed and monitored
laboratory data
Collaborative:
1. increases amount of
oxygen available for
myocardial uptake
2. Important for emergency
drugs in presence of chest
pain
3. Enzymes monitor
resolution of infarct.

Assessment Diagnosis Planning Intervention Rationale Evaluation

Risk Factors include: Risk for Short term: Independent: Independent:
Interruption of blood ineffective After 4 hours of 1. Investigated sudden changes or 1. Cerebral perfusion is
flow due to tissue nursing continued alteration in directly related to cardiac
atherosclerotic plaque perfusion intervention, client mentation. output.
will demonstrate 2. Inspect for pallor, cyanosis, 2. Systemic vasoconstriction
Chest discomfort adequate perfusion mottling, cool/clammy skin. resulting from diminished
Anxiety Note strength of peripheral cardiac output may be
Cool clammy skin Long Term: pulse. evidenced by decreased
Full, bounding pulse After 8 hours of skin perfusion and
Constipation nursing diminished pulses.
Weakness (Lovett 3/6) intervention, client 3. Cardiac pump failure or
will maintain 3. Monitor respiration, note work ischemic pain may
Vital signs: adequate perfusion of breathing. precipitate respiratory
T: 36.2 distress
PR: 102 4. Decreased
RR: 22 4. Monitor intake, note changes in intake/persistent nausea
BP:140/90 urine output. Record urine may result to reduced
O2: 94% specific gravity as indicated. circulating volume, which
VAS 5/10 negatively affects perfusion
Intake: 720mL and organ function
Output:860mL
5. Assess GI function, noting
anorexia, decreased/absent
bowel sounds, nausea/vomiting,
abdominal distention,
constipation.
6. Encourage passive leg exercises
and avoidance of isometric
exercises.
Collaborative:
1. Administer oxygen via face mask
at 5lpm, as indicated.
2. Monitor laboratory data such as
Creatinine, electrolytes and
coagulation studies.
5. Reduced blood flow to
mesentery can produce GI
dysfunction. Problems may
be potentiated/aggravated
by use of analgesics,
decreased activity and
dietary changes.
6. Enhances venous return.
Isometric exercises can
adversely affect cardiac
output by increasing
myocardial workload
Collaborative
1. May relieve discomfort
associated with myocardial
uptake
2. Indicators of organ
perfusion/ function.
Abnormalities in
coagulation may occur as a
result of therapeutic
measures (Heparin)
3. Administer medications as 3.
indicated:
1. ASA ASA reduces MI mortality.

2. Heparin Reduces risk of

thrombophlebitis or mural
thrombus formation
Assessment Diagnosis Planning Intervention Rationale Evaluation

Subjective Anxiety related Short term: Independent: Independent: Goal met

Patient verbalized to change in After 2 hours of 1. Promoted expression of feeling 1. Verbalization of concerns
Natatakot ako health status nursing and fears. Let patient know reduces tension, verifies
baka mamatay ako interventions, the these are normal reactions level of coping and
Hindi ko alam kung client will report facilitates dealing with
ano na mangyayari anxiety is reduced feeling
sakin to a manageable 2. Encouraged family and friends to 2. Reassures client that role
level treat client as before in the family has not been
Objective altered
Patient appears Long term: 3. Told the client the medical
grim After 2 days of regimen has been designed to 3. Encourage client to test
Restlessness nursing reduce/limit future attacks and symptom control, to
Vital signs: intervention, client increase cardiac stability increase confidence in
PR: 110bpm will demonstrate medical program and to
BP: 140/90 effective coping integrate abilities into
RR: 25 breaths per strategies and perceptions to self
minute problem solving
O2 Sat: 94% skills
Assessment Diagnosis Planning Intervention Rationale Evaluation

4. Monitored vital signs 4. Identifies physical response

associated with medical
and emotional condition

5. Established therapeutic 5. Avoids the contagious

relationship, conveying empathy effect or transmission of
and unconditional positive anxiety
regard

Collaborative: Collaborative:
1. Administer supplemental oxygen 1. May relieve discomfort
by face mask at 5Lpm as associated with myocardial
indicated uptake
2. Administer sedatives as 2. May be desired to help
indicated client relax until physically
able to reestablish coping
strategies

Assessment Diagnosis Planning Intervention Rationale Evaluation

Subjective: Activity Short term: Independent: Independent Goal met
Patient verbalizes Intolerance After 1 hour of 1. Determined patients response 1. Establishes patient;s
Nanghihina ako at (Level IV) nursing intervention, to activity capabilities and needs and
Sumasakit dibdib ko Related to patient will be able facilitates choice of
pag gumagalaw imbalance to participate in intervention.
ako between desired activities and 2. Record/documented heart rate, 2. Trend determine clients
Objective: myocardial meet self-care needs rhythm and BP changes before, response to activity and
Alteration in blood oxygen, supply during, and after activity as may indicate myocardial
pressure with and demand Long Term: indicated. Correlate with reports oxygen deprivation that
activity (from secondary to After 24 hours of of chest pain and shortness of may require decrease in
120/80 to 140/90) AMI nursing intervention, breath activity level.
Cool and clammy patient may achieve 3. Encouraged rest, initially. 3. Reduces myocardial
extremities measurable increase Thereafter, limit activity on basis workload and oxygen
Patient appears in activity tolerance of pain/adverse cardiac consumption, reducing risk
weak response. Provide nonusers of complications.
Chest pain (VAS diversional activities
5/10) 4. Instructed the client to avoid 4. Activities requiring holding
Complete bed rest increasing abdominal pressure. of breath and bearing
without bathroom down can result to
privileges bradycardia and rebound
Functional level: tachycardia
Level IV
Assessment Diagnosis Planning Intervention Rationale Evaluation

Vital signs: 5. Assisted with activity and 5. Until healing occurs activity
T: 36.2 progressive ambulation is limited and advances
PR: 102 slowly according to
RR: 22 individual intolerance
BP:140/90 6. Encouraged and facilitated early 6. The longer the patient
O2: 94% ambulation and other ADLs remains immobile the
VAS 5/10 when possible. greater the level of
debilitation that will occur
7. Scheduled activities with 7. To reduce fatigue
adequate rest periods during the
day
8. Encouraged participation in self 8. To enhance self concept
care occupational activities and sense of independence
9. Provided all personal belongings 9. To conserve energy
within reach and provided
bedside commode