ANGINA

ANGINA
EPISODES OF PAIN OR PRESSURE IN THE ANTERIOR
CHEST
ETIOLOGY INSUFFICIENT CORONARY BLOOD FLOW
RESULTING IN A DECREASED OXYGEN SUPPLY TO
MEET AN INCREASED MYOCARDIAL DEMAND IN
RESPONSE TO PHYSICAL EXERTION OR EMOTIONAL
STRESS

TYPES OF ANGINA

STABLE
UNSTABLE
INTRACTABLE OR REFRACTORY
VARIANT
SILENT

FACTORS ASSOCIATED WITH ANGINA

PHYSICAL EXERTION
EXPOSURE TO COLD
HEAVY MEALS
STRESS

MANIFESTATIONS

CHEST PAIN POORLY LOCALIZED AND MAY RADIATE TO THE NECK, JAW,
SHOULDERS, LEFT ARM
FEELING OF INDIGESTION
CHOKING , TIGHTNESS, HEAVY SENSATIONTHAT HAS A VISELIKE, INSISTENT
QUALITY
FEELING OF WEAKNESS OR NUMBNESS
SHORTNESS OF BREATH
PALLOR
DIAPHORESIS
DIZZINESS
LIGHTHEADEDNESS
NAUSEA
VOMITING
ANXIETY

ASSESSMENT/ DIAGNOSTICS

HISTORY
12 LEAD ECG
ECHOCARDIOGRAM
NUCLEAR SCAN
CARDIAC CATHERIZATION
BLOOD LAB VALUES
C-REACTIVE PROTEIN
TOTAL CHOLESTEROL LDL, VLDL, HDL
TRIGLYCERIDES

MEDICAL MANAGEMENT
AIMED AT DECREASING THE OXYGEN DEMAND OF THE
MYOCARDIUM AND TO INCREASE THE OXYGEN SUPPLY
REVASCULARIZATION PROCEDURES
CABG
PERCUTANEOUS TRANSLUMINAL MYOCARDIAL REVASCULARIZATION
PERCUTANEOUS CORONARY INTERVENTIONAL PROCEDURES

PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

(PTCA)
INTRACORONARY STENTS
ATHERECTOMY

MEDICATIONS

NITROGLYCERIN
BETA BLOCKERS
CALCIUM CHANNEL BLOCKERS
ANTIPLATELET / ANTICOAGULANTS

NURSING PROCESS
ASSESSMENT
FACTORS ABOUT PAIN THAT NEEDS TO BE ASSESSED

POSITION/ LOCATION
PROVOCATION
WUALITY
QUANTITY
RADIATION
RELIEF
SEVERITY
SYMPTOMS
TIMING

NURSING PROCESS
NURSING DIAGNOSES
INEFFECTIVE MYOCARDIAL TISSUE PERFUSION SECONDARY
TO CORONARY ARTERY DISEASE
ANXIETY RELATED TO FEAR OF DEATH
KNOWLEDGE DEFICIT ABOUT THE UNDERLYING DISEASE
NONCOMPLIANCE, INEFFECTIVE MANAGEMENT OF
THERAPEUTIC REGIMEN RELATED TO FAILURE TO ACCEPT
NECESSARY LIFESTYLE CHANGES

NURSING PROCESS
PLANNING AND GOALS

TREATMENT OF ANGINA
REDUCTION OF ANXIETY
AWARENESS OPF DISEASE PROCESS
UNDERSTANDING OF PRESCRIBED CARE
ADHERENCE TO SELF-CARE PROGRAM
ABSENCE OF COMPLICATIONS

NURSING PROCESS
INTERVENTIONS
TREAT ANGINA
REDUCE ANXIETY
PREVENT PAIN
PROMOTE HOME AND COMMUNITY BASED CARE

NURSING PROCESS
EVALUATION
CLIENT OUTCOMES

REPORT THAT PAIN IS RELIEVED PROMPTLY

REPORTS DECRESED ANXIETY
UNDERSTANDS WAYS TO AVOID COMPLICATIONS
DEMONSTRATES FREEDOM FROM COMPLICATIONS
ADHERES TO SELF CARE PROGRAM

NURSING PROCESS
PLANNING

RELIEF OF PAIN OR ISCHEMIC SIGNS AND SYMPTOMS

PREVENTION OF FURTHER MYOCARDIAL DAMAGE
ABSENCE OF RESPIRATORY DYSFUNCTION
MAINTENANCE OF ADEQUATE TISSUE PERFUSION
REDUCE ANXIETY
ADHERENCE TO SELF-CARE PROGRAM
ABSENCE OR EARLY RECOGNITION OF COMPLICATIONS