Angina Pectoris is described as severe chest pain that results from insufficient blood flow to the heart. The main cause is a coronary artery disease called atherosclerosis, or a clogging of the arteries.
Signs and symptoms of this heart related condition may include tightness or pressure in the chest that may radiate to the left shoulder and arm, or possibly the neck and jaw. Other symptoms may include difficulty breathing, anxiety, sweating, or pale skin.
During an attack of angina pectoris, a person should rest and take nitroglycerin under the tongue. This may be enough to eliminate the symptoms. Depending on possible underlying conditions, other treatment such as balloon angioplasty or other surgeries may be recommended, or certain medications (beta-blockers, daily aspirin) may be needed. In most cases, a patient can benefit from a healthy diet and exercise, which should be prescribed by their doctor.
Nursing Diagnosis : Acute Pain related to Myocardial Ischemia
Goal: reduced pain / resolved
Outcomes:
- Stated / said no pain,
- Reported angina episodes decreased in frequency, duration and severity.
1. Instruct the patient to notify nurse quickly in the event of chest pain.
R:/ pain and decreased cardiac output can stimulate the sympathetic nervous system to release large amounts of nor epinephrine, which increases platelet aggregation and thromboxane A2 issued. Pain can not be detained cause vasovagal response, reducing BP and heart rate.
2. Identification of the precipitating factors, if any: frequency, duration, intensity and location of pain.
R: / Help distinguish early chest pain (stable angina usually ends 3 to 5 minutes while unstable angina longer and can last more than 45 minutes).
3. Evaluation report pain in the jaw, neck, shoulder, hand or arm (especially on the left side).
R:/ Cardiac pain may spread to the sample surface pain more often innervated by the same spinal level.
4. Instruct the patient to bed rest during episodes of angina.
R:/ Reduce myocardial oxygen demand in order to minimize the risk of tissue injury or necrosis.
5. Elevate the head of the bed when the patient is short of breath.
R:/ Facilitate the exchange of gases to reduce repetitive hypoxia and shortness of breath.
Monitor the speed or rhythm of the heart.
6. Monitor the speed or rhythm of the heart.
R:/ Patients with unstable angina have increased dysrhythmias, acute life-threatening, which occurs in response to ischemia and or stress.
7. Panatau vital signs every 5 minutes during an attack of angina.
R:/ BP can rise early with respect to sympathetic stimulation , then dropped when the cardiac output is affected.
8 . Maintain a calm, comfortable environment, limit the visitor when necessary.
R:/ mental or emotional stress increase myocardial work.
9. Give soft foods. Let the patient rest for 1 hour after eating.
R :/ Lowering myocardial work in connection with the work of digestion, lowers the risk of angina attacks
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