Unstable Angina: Unstable angina is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead to a heart attack.
Causes Symptoms/Signs Differences between others anginas Treatments Nursing Implications
Coronary artery disease due to atherosclerosis is by far the most common cause of unstable angina.
Atherosclerosis is the buildup of fatty material called plaque along the walls of the arteries. This causes arteries to become narrowed and less flexible.
The narrowing interrupts blood flow to the heart, causing chest pain.
Some of the risk factors are :
Diabetes, smoking, High LDL cholesterol Low HDL cholesterol. Male gender. Not getting enough exercise. Obesity and older age.
Chest pain associated with UA is new onset, occurs at rest, or has a worsening pattern.
Discomfort, weakness, nausea, vomiting, diaphoresis, SOB, fatigue and hypotension. Patient with chronic stable angina may develop UA or been the first manifestation of CAD. Unlike chronic stable angina UA is unpredictable and represents an emergency. Nitroglycerin, morphine and O2.
Blood thinners (antiplatelet drugs
Aspirin, clopidogrel.
heparin (or another blood thinner Nursing interventions in the initial included pain assessment and relieve, physiological monitoring promotion of rest and comfort, alleviation of stress and anxiety and understanding the patients emotional and behavioral reactions.
Maintain continuous ECG monitoring while the patient is in ED or ICU.
Frequent V/S assesses, check intake and output at least once per shift.
Assess lungs and heart sounds and inspect for evidence of early heart failure, e.g. tachycardia, dyspnea. pulmonary congestion,
Assess patient saturation status, especially if the patient is recei...
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...nce. The pain or discomfort:
May be more severe and last longer than other types of angina pain.
May occur with shortness of breath, sleep problems, fatigue, and lack of energy
Often is first noticed during routine daily activities and times of mental stress
Statins, angiotensin-converting enzyme inhibitors, or low-dose aspirin), as well as treatment for angina and myocardial ischemia (with β-blockers, calcium channel blockers, nitrates, or Ranolazine). Additional symptom management techniques may include tricyclic medication, enhanced external counter pulsation, hypnosis, and spinal cord stimulation. Administered Medications as ordered.
Assess vital signs.
Monitor for potential side effects of medications.
Educate patient with the description of his/her condition of Cardiac Syndrome X.
Cardiac Monitor to detect changes in ST segment and/or arrhythmias.
It occurs because of repetitive electrical activity. This can occur in a patient with early or late heart failure, because there is damage to the heart tissue and the heart beats faster to try to supply the body with blood. Recommended treatment is elective cardioversion. Drugs used include an antidysrhythmic such as Mexitil or Sotalol (Ignatavicius &Workman, p. 728-729).
Physical pain is more easily addressed by the administration of medication or a non-pharmaceutical intervention like repositioning, or the application of heat or cold. Nursing care on a general medical unit is about patient and family centered care which is in alignment with Kolcaba’s Theory of Comfort. A large portion of the patients seen on this type of unit have multiple comorbidities and challenging social situations that require assessment of their past health history, their support system, and their current living situation. All of this is taken into consideration in multidisciplinary rounds where data that is collected is communicated to all disciplines and a plan of care developed for each patient. The unit which I currently manage assembles our multidisciplinary unit daily. Needs are identified and assigned to the team members who include social work, care management and therapies in addition to the nurses and the providers. Since the team meets daily there is an opportunity to evaluate the effectiveness of the interventions prescribed. Nursing care management is integral in this work as part of the assessment, planning, and coordination of care in the hospital
Atherosclerosis begins when the inner wall of the artery becomes damaged and cholesterol and fatty plaques begin to lodge in the arteries. Damage to the endothelial wall inside the artery can be caused by hypertension, hyperlipidemia, and hyperglycemia (“Subclinical Atherosclerosis..” 443). When this happens, the immune system responds by sending monocytes to the damaged area. The monocytes turn into macrophages; their job is to eat up the excess cholesterol and unblock the artery. The macrophages are unable to digest all of the cholesterol, and as a result turn in to foam cells. When many macrophages are turned into foam cells, plaque results, and protrudes into the arterial wall, restricting blood flow and raising blood pressure (“Atherosclerosis Growth Process.” 8). If the plaque becomes too large it may break, releasing plaque into the blood. This can cause a great reduction in blood flow or a clot, resulting in stroke or myocardial infarction (“Stroke Risk.” 3).
Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
Coronary heart disease is defined by the hardening of the epicardial coronary arteries. The buildup of plaque in the arteries slowly narrows the coronary artery lumen. In order to better understand the physiology of the disease, it is important to first know the basic anatomy of the human heart. The aorta, located in the superior region of the heart, branches off into two main coronary blood vessels, otherwise known as arteries. The arteries are located on the left and right side of the heart and span its surface. They subsequently branch off into smaller arteries which supply oxygen-rich blood to the entire heart (Texas Heart Institute, 2013). Therefore, the narrowing of these arteries due to plaque buildup significantly impairs blood flow throughout the heart.
Other symptoms are breathing frequent and superficial, the fever and then can often present a noise very particular in the chest area, which is heard through the stethoscope. The symptom picture is completed by shortness of breath, sobs, anemia and decreased body weight.
CHD is primarily due to atherosclerosis, which is the blockage of blood flow in the arteries due to the accumulation of fats, cholesterol, calcium and other substances found in the blood. Atherosclerosis takes place over many years, but when the blood flow becomes so limited due to the build up of plaque in the arteries, there becomes a serious problem. “When...
Myocardial infarctions are caused by vascular endothelial disruption most often associated with plaque build-up or atherosclerosis that develops over several years and causes thrombus formation which in turn
Coronary heart disease or coronary artery disease affects 16.8 million people in the United States and causes more than 607,000 deaths annually (Lemone, chap.30). It is caused by atherosclerosis which is the accumulation of fatty deposits in the arteries causing impaired blood flow to the myocardium. CAD or coronary artery syndrome is usually without symptoms but may induce heart attack, angina and acute coronary syndrome if not properly treated. There are many risk factors associated with CAD like obesity, high cholesterol diet, hereditary, physical inactivity, just to name a few. Patients with CAD may be unable to identify and manage their risks factors. It is imperative for nurses to educate the patient about CAD and measures to enhance their health.
The general idea of, K, is that a nurse must have knowledge in the diversity of cultures, ethics, and education. The significance of this faction being that if the nurse is cognizant of the patient 's culture, beliefs, family values, support systems, and education level, a more thorough and comprehensive plan of care can be formulated. The premise of, S, is that a nurse must be skilled in the ability to communicate with and advocate for the patient, assess for and properly treat pain, and incorporate the needs and concerns of the patient and their family. The significance of this group and development of these skills include the achievement of pain control, increased rehabilitation periods, and an increase in patient/family satisfaction. The theme of, A, requires that a nurse maintains an open attitude toward the patient and to respect and validate the nurse-patient relationship, which will aid in a positive nurse-patient
of fatty substances on the inside wall of the arteries). It is not caused by
Acute coronary syndrome pertains to a sudden changes in the heart’s blood supply. It can range from the development of
CAD can also cause, what is called Arrhythmia, or a fast heartbeat. Arrhythmia can range from slow, fast or an irregular heartbeat, there are also indications of anxiety, shortness of breath, and weakness. In severe cases arrhythmia can change, slow or even stop the heart’s power to pump blood. Coronary Artery disease also effects the kidneys, organs that are bean shaped, about the size of a fist. The kidneys are located just under the ribs and there is one on each side of the spine. In twenty-four hours the kidneys can screen about 120 to 150 quarts of blood to create roughly one two quarts of urine. The urine flows through two slim tubes of muscle called ureters that are located from the kidneys to the bladder. There is one ureter on each
Cardiovascular System: He does not experience any chest pain or palpitation. He does not have dyspnea or leg swelling.
Nurses are an equally important part of each client’s life. Nurses provide stable care to each client, answers their questions, gives medications and treatments, and assists with medical procedures. They also have the responsibility to explain to clients and family members what they should and should not do as they go through treatment and recovery. Nurses must quickly respond to patients needs. Every individual nurse has his or her own unique way of caring. There are so many ways to show caring that the possibilities are never ending. Nurse’s support, comfort, and help allow the patients to recover to the best of their ability. Their experiences in dealing with different patients that have unique situations on a daily basis helps the nurses become better caregivers. Therefore, every nurse is capable of demonstrating care in their respective environments.