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    Angina Pectoris

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    John Matley Caampued
    Myrna, a 56-year-old woman, experienced chest pain while raking leaves and was diagnosed with stable angina pectoris. The nurse would differentiate angina from a myocardial infarction based on the characteristics and duration of chest pain. After discharge, Myrna experiences pain when climbing stairs to visit a friend. The nurse would advise her to rest in a semi-Fowler's position when experiencing angina to reduce oxygen demands on the heart. Myrna is scheduled for a percutaneous transluminal coronary angioplasty to treat her angina, and the nurse's priority goals after the procedure are to maintain bed rest and reduce cardiac workload through medications to restore coronary blood flow.

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    Angina Pectoris

    Uploaded by

    John Matley Caampued
    94 views11 pages
    Myrna, a 56-year-old woman, experienced chest pain while raking leaves and was diagnosed with stable angina pectoris. The nurse would differentiate angina from a myocardial infarction based on the characteristics and duration of chest pain. After discharge, Myrna experiences pain when climbing stairs to visit a friend. The nurse would advise her to rest in a semi-Fowler's position when experiencing angina to reduce oxygen demands on the heart. Myrna is scheduled for a percutaneous transluminal coronary angioplasty to treat her angina, and the nurse's priority goals after the procedure are to maintain bed rest and reduce cardiac workload through medications to restore coronary blood flow.

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    Myrna, a 56-year-old woman, experienced chest pain while raking leaves and was diagnosed with stable angina pectoris. The nurse would differentiate angina from a myocardial infarction based on the characteristics and duration of chest pain. After discharge, Myrna experiences pain when climbing stairs to visit a friend. The nurse would advise her to rest in a semi-Fowler's position when experiencing angina to reduce oxygen demands on the heart. Myrna is scheduled for a percutaneous transluminal coronary angioplasty to treat her angina, and the nurse's priority goals after the procedure are to maintain bed rest and reduce cardiac workload through medications to restore coronary blood flow.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    94 views11 pages

    Angina Pectoris

    Uploaded by

    John Matley Caampued
    Myrna, a 56-year-old woman, experienced chest pain while raking leaves and was diagnosed with stable angina pectoris. The nurse would differentiate angina from a myocardial infarction based on the characteristics and duration of chest pain. After discharge, Myrna experiences pain when climbing stairs to visit a friend. The nurse would advise her to rest in a semi-Fowler's position when experiencing angina to reduce oxygen demands on the heart. Myrna is scheduled for a percutaneous transluminal coronary angioplasty to treat her angina, and the nurse's priority goals after the procedure are to maintain bed rest and reduce cardiac workload through medications to restore coronary blood flow.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 11

    CASE ANALYSIS

    Angina Pectoris

    Situation
    Myrna a 56 year old woman has felt brief twinges of chest pain for the past few months while working in her garden and has frequent episodes of indigestion. She comes to the hospital after experiencing severe anterior chest pain while raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris.

    1. How would the nurse differentiate angina pectoris from myocardial infarction?

    Angina is typically felt as a heavy, squeezing pain in the center of the chest. Also may spread to the neck, jaw, back and left arm. Attack last for several minutes, often brought by physical activity, emotional stress, cold weather or digestion of a heavy meal and all factors that can increase cardiac work load. While myocardial infarction is typically feels an intense, crushing pain in the chest especially on left arm that may radiate to the neck, jaw and left arm. The pain is similar to angina but more intense & longer lasting often caused by build up of fatty deposits called plaque that block blood flow through coronary arteries.

    2. After stabilization and treatment, the client is discharge from the hospital. At her follow-up appointment she is discouraged because she is experiencing frequency. She states that she visits an invalid friend twice a week and now she cannot walk up the second flight of stairs to her friends apartment without pain. Which measure would the nurse suggest to help her deal with problem? When the patient experiences angina, the nurse directs the patient to stop all activities and sit or rest in bed in a Semi-fowlers position to reduce oxygen requirements of the ischemic myocardium. The nurse should assess the patient s angina. Asking questions to determine whether the angina is the same as the patient typically experiences. A change may indicate worsening of the disease on a different course. Assessment of vital signs and observing signs of respiratory distress. After this, initial measures are implicated such as: >put on a 12-lead ECG observed for changes in ST segment >nitroglycerin administered sublingually, if no changes occurred, it is repeated in 3 doses. >oxygen therapy if the patient s respiratory rate is increased or if oxygen saturation level is decreased. if after these interventions are made and still the pain is significant and continues, the patient is further evaluated with M.I

    3. What would be the best low cholesterol diet for the client?

    Myrna should eat a diet low in saturated fat. She must also include high-fiber in diet. And lower in calories if indicate

    4. The doctor refers the client for cardiac catheterization. What is the procedure for?

    Cardiac catheterization is used to diagnose and/or treat many heart conditions. The most common reason is to evaluate chest pain. Cardiac catheterization can show whether plaque is narrowing or blocking your heart s arteries. It involves a long, thin, flexible tube catheter, which is put into a blood vessel in your arm, groin (upper thigh) or , neck and threaded to your heart, through the catheter, doctors can do diagnostic tests and treatment on your heart.

    5. The client was schedule for percutaneous transluminal coronary angioplasty to treat her angina. What are the priority goal of the nurse after the PTCA of the client?

    Since Percutaneous Transluminal Coronary Angioplasty is a non invasive procedure, the priority nursing goal will be on the restoration of coronary blood flow. This can be obtain by maintaining the client bed rest, decreasing the cardiac workload, pharmacologic treatment as ordered by the physician such as opiate analgesics, vasodilators, betaadrenergic blockers, calcium channel blockers and antiplatelet.

    . What are the risk factors for the development of atherosclerosis? Modifiable y Diabetes or Impaired glucose tolerance y Dyslipoproteinemia y Tobacco Smoking y Hypertension y Vitamin B6 deficiency Non- Modifiable yAdvanced age yMale sex yHaving close relatives who have had some complication of atherosclerosis(e.g coronary heart disease or stroke) yGenetic abnormalities(familial hypercholesterolemia) yPost-menopausal Estrogen deficiency

    7. An ECG was done for the client for what purpose?


    y An Electrocardiogram or ECG, is a recording at the electrical changes

    y y

    that occur in the myocardium during carding cycle. (This pattern occurs as action potentials stimulate cardiac muscle fibers to contract, but it is not the same as individuals action potentials). ECG detects dysrythmias and alteration in condition indicative of myocardial damage, enlargement of the heart or drug effects. ECG is very significant in detecting AP because their is presence of myocardial ischemia thus resulting in alterations in the conduction system of the heart for example. Stable Angina: ST-segment depression because the ischemia is most intense in the sub-endocardial region of the left ventricular myocardium. Prinzmetal: ST segment elevation during the vasospastic attack, reflecting transmural ischemia. Unstable: ST segment depression and ST segment elevation

    8. The physician prescribed Nitroglycerine tablets, 0.3mg given sublingually. What are the drugs principal effects?

    It inhibits Ca transport into the myocardial & vascular smooth muscle cells, suppressing contractions. Dilates main coronary arteries and arterioles, inhibits coronary artery spasm. Increased O2 delivery to the heart, & decreased frequency and severity of angina attacks.

    9. What are the common side effects of the drugs?

    y -Headache y -Transient flushing of face y -Dizziness y -Weakness y -Orthostatic hypotension. y - Burning, tingling sensation at oral of dissolution.

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