Angina Pectoris Care Plan Essay Example for Free

Angina Pectoris C atomic number 18 Plan EssayCare Plan For Angina Pectoris Angina Pectoris Chief bursting charge Patient complains of having tightness and pain in his chest that seems to move down the left arm. Patient describes the pain as being sharp and can be sometimes a mild pain or an immobilizing pain. Medical Diagnosis Coronary Artery Disease Pathophysiology of Angina Pectoris Angina Pectoris develops when coronary transmission line flow becomes inadequate to meet myocardial oxygen demand. This causes myocardial cells to switch from aerobic to anaerobic metabolism, with a progressive impairment of metabolic, mechanical, and electrical functions. Angina pectoris is the nearly common clinical manifestation of myocardial ischemia. It is caused by chemical and mechanical stimulation of sensory afferent nerve endings in the coronary vessels and myocardium. These nerve fibers take from the first to fourth thoracic spinal nerves, ascending via the spinal cord to the thalamus , and from there to the cerebral cortex. (http// emedicine. medscape. com/article/15021 5-overview, 6/1 5/10 1230 pm) Medical Interventions Diagnostic Tests 1.Coronary intravascular ultrasonography A coronary intravascular ultasonography is an invasive ultrasound performed rom a transducer within the lumen of the coronary arteries. (Laboratory see and diagnostic procedures, By Cynthia Chernicky, 5th Edition 2008). Electrocardiography is a noninvasive acoustic imaging procedure that determines the size, shape, position, thickness and movements of the heart valves, walls, and chambers during separately cardiac cycle. (Laboratory visitation and diagnostic procedures, By Cynthia Chernicky, 5th Edition 2008). Lipid Profile Blood 3.Lipid profile crosscurrent is a test to check the units of each of the following Total lipids, A. Triglycerides B. HDL Cholesterol C. LDL Cholesterol D. E. Total HDL Cholesterol ratio. 4. Stress Exercise Test Stress exercise test measures the efficiency of the heart during a period of sensual stress on a treadmill or on a stationary bicycle. Medications 1. Nitroglycerin T fittingts compartmentalization Vasodilator, antihypertensive. Action Reduces preload and afterload, decreasing myocardial workload and oxygen demand. Uses To prevent or treat angina pectoris, hypertension, and heart failure.Contraindications Acute Myocardial Infarction, angle- closure glaucoma, cerebral hemorrhage, synchronous use of phosphodiesterase inhibitors, constrictive ericarditis. Route and Dosage Adults PO 1 mg. tablet every 5 hours while awake. (Buccal) 0. 1 To 0. 8 mg. hr. worn 12 to 14 hours at a time. (Transdermal Patch) Adverse Reactions Some aspect effects of this drug that should be reported to a healthcare provider if they become gruelling are as follows headaches dizziness flushing lightheadedness reported to a healthcare provider immediately.The adverse effects of nitroglycerin are Nausea vomiting Weakness fuzzed vision fainting spell abdomin al pain sweating chest pain pale skin rashes ? peeling of the skin blisters on the skin hives itching difficulty breathing Surgery 1 Transluminal coronary angioplasty Your hearts arteries can become occlude from a buildup of cholesterol, cells or other substances. This can reduce blood flow to your heart and cause chest discomfort.Sometimes a blood clot can suddenly form or get worse and all told block blood flow, leading to a heart attack. Angioplasty opens blocked arteries and restores normal blood flow to your heart muscle. Angioplasty, a type of percutaneous coronary hindrance (PCI), is not major surgery. It is done through a small puncture in a leg or arm artery and opens a clogged heart artery by inflating a tiny balloon in it. Assessment Subjective Patient is a 68 year old virile with a history of coronary artery disease, and hypertension.Vital Signs as follows -r 986 R 25 p 102 Objective Patient seemed to be crying and in severe pain. Skin was flushed, and clammy. Right hand was over left shoulder as if he were trying to relieve the pressure of the pain. Nursing Diagnosis 1 somatic 1. Acute pain related to decreased oxygen supply to the myocardium. Nursing Intervention . Patient will remain on oxygen as staged for the next 12 hours. 2. Give Nitroglycerin Tablets sublingually every 5 minutes for the next 1 5 minutes. . Patient will rest period for at least 30 minutes every 2 hours for the next 8 hour shift. Nursing Evaluation/Outcome 1. Patient was able to be taken pip of oxygen after the first 12 hours. 2. Patients pain had stopped after 1 5 minutes of administration of the nitroglycerin tablets. 3. Patient was able to sleep for 30 minutes every 2 hours with no interruptions in the last 8 hour shift. Nursing Diagnosis 2 Psychosocial 1. Anxiety related to multifariousness in lifestyle. Nursing Interventions 1.Patient will be informed of the importance of taking the nitroglycerin at first sign of pain within an 8 hour shift. 2. Patient will lea rn how to decrease personal activities within 30 days. 3. Patient will Join a stress management variant within the next month. 1. Patient was able to better understand the use of the nitroglycerin tablets after an 8 hour shift. 2. Patient was able to decrease physical activities in the last 30 days. 3. Patient was able to Join a stress management course in last month. Potential/ Risk 1. Deflecient intimacy related to coronary artery disease. . Patient will learn the causes of angina pectoris within an 8 hour shift. 2. Patient will learn the importance of side effects to medications within 8 hours. 3. Patient will make sure to get all information of medications before leaving the hospital. 1. Patient was better able to understand what caused the angina pectori by the time he left the hospital. References 1. Laboratory test and diagnostic procedures, By Cynthia Chernicky, 5th Edition 2008. 2. http//emedicine. medscape. com/article/1 5021 5-overview, 6/1 5/10 1230 pm