Nursing care plan in patient with Kounis syndrome
Section: Casos clínicos
How to quote
Enferm Cardiol. 2019; 26 (78): 88-94.
Authors
Marta Parellada Vendrell1, Montserrat Prat Masana2, Silvia Pérez Ortega3.
Position
1 MSc Enfermera de la Unidad de cuidados cardiológicos agudos. Instituto Clínico Cardiovascular. Hospital Clínic Barcelona. 2 RN Enfermera de la Unidad de cuidados cardiológicos agudos. Instituto Clínico Cardiovascular. Hospital Clínic Barcelona. 3 PhD(c) Enfermera clínica del Instituto Clínico Cardiovascular. Hospital Clínic Barcelona.
Contact address
Marta Parellada. Vendrell Hospital Clínic Barcelona. Unidad de cuidados cardiológicos agudos. C/ Villarroel, 170. 08036 Barcelona
Contact email: maparell@clinic.cat
Abstract
Introduction. The Kounis syndrome is characterized by the simultaneous appearance of acute coronary events and anaphylactic allergic reactions. An unusual, little known, underdiagnosed pathology with a multifactorial aetiology. The aim is to establish a care plan, intended for a patient with Kounis syndrome admitted to the Acute Cardiological Care Unit.
Case description. A 62-year-old man who consults because of dental pain and who is on treatment with amoxicillin-clavulanic acid, diclofenac and metamizole. At home, he presents with acute myocardial infarction with nonsustained monomorphic ventricular tachycardia. Infarction code is activated, showing coronary arteries without significant lesions. The anaphylactic reaction appeared in the form of coronary vasospasm, skin rash and wheezing. Nursing observation allowed for the early detection of those cutaneous reactions that favoured his immediate treatment and for the definition of the diagnosis.
Care planning. Nursing assessment was performed using Marjory Gordon‘s functional patterns. A care plan was developed following the NANDA-NIC-NOC taxonomy, thereby identifying the following diagnoses: Acute pain; Shock risk; Bleeding risk; Fear; Poor knowledge; Inefficient health maintenance, and anaphylaxis as a problem of collaboration.
Reflection on the case. Providing objective information is vital for the patient and his family to become aware of the severity of the episode, but at the same time it is an essential tool to reduce fears, clear up any questions, promote self-care and recommend allergy tests so as to determine which drug is causing the Kounis syndrome.
The study, knowledge and scientific dissemination of these syndromes help us to provide more effective nursing care.
Keywords:
critical care; Kounis syndrome; acute coronary syndrome; anaphylaxisnursing care
Versión en Español
Título:
Plan de cuidados de enfermería en paciente con síndrome de Kounis
Artículo completo no disponible en este idioma / Full article is not available in this language
Bibliography
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