Page 140 - Critical Care Nursing Demystified

Chapter 3 CARE OF THE PATIENT WITH CRITICAL CARDIAC AND VASCULAR NEEDS 125

Other associated signs/symptoms may include
• Nausea

• Diaphoresis
• Dizziness
• Anxiety and apprehension
• Feeling of numbness or weakness in extremities

NURSING ALERT

The difference between an acute coronary event and angina is that angina is relieved
with rest, oxygen, and nitroglycerin. Angina that increases in frequency, duration, or is
unrelieved with nitrates, oxygen, and rest requires medical intervention.

Treatment

Rest is in order to decrease the demand upon the heart.
Oxygen to increase myocardial oxygenation.
Self-administration of nitroglycerin to dilate the veins and decrease the pre-
load to the heart. Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
Aspirin to prevent platelets from adhering together and causing coronary
artery thrombosis.
Metoprolol to help strengthen the heart’s contractions.

NURSING ALERT

Some patients never experience pain or pressure and yet could have a coronary
event. Women, the elderly, and patients with diabetes must be monitored closely as
they can have atypical symptoms.

Nursing Diagnoses for Angina Expected Outcomes
Acute pain related to coronary The patient will report 0 pain on 1–10
artery occlusion scale after administration of nitrates
and rest

Nursing Interventions
Assess the patient using organized pain assessment to ensure a complete,
comprehensive assessment.