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DIAGRAM OF PATHOPHYSIOLOGY
Non Modifiable
Modifiable
Smoking
Male
52
Nursing Management
1. Monitor blood pressure, apical heart
rate, and respirations every 5
minutes during an anginal attack.
2. Maintain continuous ECG monitoring
or obtain a 12-lead ECG, as
directed, monitor for arrhythmias and
ST elevation.
3. Place patient in comfortable position
and administer oxygen, if prescribed,
to enhance myocardial oxygen
supply.
4. Identify specific activities patient
may engage in that are below the
level at which anginal pain occurs.
5. Reinforce the importance of notifying
nursing staff whenever angina pain
is experienced.
6. Encourage supine position for
dizziness caused by antianginals.
7. Be alert to adverse reaction related
to abrupt discontinuation of betaadrenergic blocker and calcium
channel blocker therapy. These drug
must be tapered to prevent a
rebound phenomenon; tachycardia,
increase in chest pain, and
hypertension.
Angina, Shortness of
breath, Dyspnea,
Heart Attack
Medical Management
1. Antianginal medications
(nitrates, beta-adrenergic
blockers, calcium channel
blockers, and angiotensin
converting enzyme inhibitors) to
promote a favorable balance of
oxygen supply and demand.
2. Antilipid medications to
decrease blood cholesterol and
tricglyceride levels in patients
with elevated levels.
3. Antiplatelet agents to inhibit
thrombus formation.
4. Folic acid and B complex
vitamins to reduce
homocysteine levels.
Surgical Management
1. Percutaneous
transluminal coronary
angioplasty or
intracoronary
atherectomy, or
placement of
intracoronarystent.
2. Coronary artery
bypass grafting.
3. Transmyocardial
revascularization.
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8. Explain
to
the
patient
the
importance of anxiety reduction to
assist to control angina.
9. Teach
the
patient
relaxation
techniques.
10. Review specific factors that affect
CAD development and progression;
highlight those risk factors that can
be modified and controlled to
reduce the risk.
Prognosis
Restoration of Health
If not treated:
Good Prognosis
Bad Prognosis
Death