ANA - Coronary Artery Disease

Angina Ineffective tissue [blank_start]perfusion[blank_end]:Cardiac Keep the prescribed [blank_start]GTN[blank_end] tablet at the person’s side so that e can take it at the onset of [blank_start]pain[blank_end]. Anginal pain indicates Myocardial [blank_start]ischaemia[blank_end] GTN causes [blank_start]vasodilation[blank_end] improving [blank_start]oxygen[blank_end] supply which relieves pain and ischaemia Plan activity to allow [blank_start]rest[blank_end] between them Teach about prescribed medications to maintain myocardial perfusion reduce cardiac work. Instruct to take sublingual [blank_start]glyceryl trinate[blank_end] before engaging in [blank_start]activities[blank_end] that precipitate angina such as (climbing stairs, sexual intercourse, etc) Encourage the person to have an [blank_start]exercise[blank_end] program under [blank_start]supervision[blank_end] of a primary care provider or a cardiac [blank_start]rehabilitation[blank_end] professional Refer individual to [blank_start]smoking cessation[blank_end] program as indicated. Risk of [blank_start]ineffective[blank_end] therapeutic regimen management Assess knowledge and understanding of [blank_start]angina[blank_end] [blank_start]Teach[blank_end] individual about angina and atherosclerosis, building on current [blank_start]knowledge[blank_end] base Provide [blank_start]written[blank_end] and [blank_start]verbal[blank_end] instructions prescribed medication and their use Stress the importance of taking [blank_start]chest pain[blank_end] seriously while maintaining a [blank_start]positive[blank_end] attitude. Refer to a [blank_start]cardiac rehabilitation program[blank_end] or other organised activities and [blank_start]support[blank_end] groups for individuals with CHD

MI Acute Pain Assess for verbal and [blank_start]non-verbal[blank_end] signs of pain. Document characteristics and the intensity of pain using a [blank_start]standard pain scale.[blank_end] Administer O2 at [blank_start]2[blank_end] to [blank_start]5[blank_end] L/min per nasal prongs. Promote physical and psychological [blank_start]rest[blank_end]. Provide information and emotional support Administer prescribed PRN medication Ineffective Tissue Perfusion Assess and document vital sign. Report [blank_start]increase in[blank_end] BP, HR change in [blank_start]rhythm[blank_end], and RR Assess for change in LOC:decrease urine output, delayed Cap [blank_start]refill[blank_end], and diminished pedal pulses Auscultate [blank_start]heart[blank_end] and breath sounds. Note for abnormal sounds Ineffective coping Established an environment of caring and trust. Encourage patient to express feelings Accept denial as a coping mechanism, but do not reinforce it Note [blank_start]aggressive[blank_end] behaviours, hostility or anger. Provide opportunities for the person to make [blank_start]decisions[blank_end] about the plan of [blank_start]care[blank_end] as much as possible Provide [blank_start]privacy[blank_end] for the person and significant other to share their questions and concerns Fear Identify the person’s [blank_start]level of fear[blank_end] noting verbal and non-verbal signs [blank_start]Acknowledge[blank_end] the person’s perception of the situation. Allow individuals to verbalise their concern Encourage questions and provide consistent, [blank_start]factual[blank_end] answers Encourage self-care Teach non-pharmacological methods of [blank_start]stress reduction[blank_end] (e.g. relaxation technique,breathing exercises, meditation, massage)