Nursing Care Plan for Coronary Artery Disease

Assessment Subjective Cue: “My chest is really in pain right now.  The pain even even travels along my neck and left arm.”, as verbalized by the patient Objective Cues:    

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Pain scale of 8!" #ool clammy skin $acial grimace Placing %st over mid& stern'm  ('bbing left arm (estlessness )ital *igns+ P'lse+ !!bpm -lood Press're+ !"!""mm/ g

Diagnosis 0c'te Pain related to decreased myocardial blood 1ow as evidenced by reports of pain and distraction behavio'rs

Planning 2b3ective+ 0fter 8 ho'rs of n'rsing intervention, the patient will be free from pain complaint.

Intervention 4ndependent

Rationale 

Pain and decreased cardiac o'tp't may stim'late the sympathetic nervo's system to release e9cessive amo'nts of norepinephrin e which may lead to coronary artery vasospasm.

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#ardiac pain may radiate.

!. 4nstr' 4nstr'ct ct to to notif notify y n'rse immediately when chest pain occ'rs.

. 0ssess 0ssess repor reports ts of of pain in 3aw, neck, sho'lder, arm or hand. 5. Place Place patien patientt at at complete bed rest d'ring angina attacks.

6. 7lev 7levat ate e head head of of bed if patient is short of breath.

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. Monito Monitorr heart heart rate rate and blood press're.

. Mainta Maintain in calm calm and and comfortable

(ed'ces myocardial o9ygen demand to minimize risk of tiss'e in3'rynecrosis .  $acilitates gas e9change to decrease hypo9ia and res'ltant shortness of breath.

Evaluation 0fter 8 ho'rs of n'rsing intervention, the patient reported no signs of pain. Pain scale of "!".

environment.

:. Prov Provid ide e light light meals.

#ollaborative !. Provi rovide de s'pplementary o9ygen as indicated.

. 0dmi 0dminis niste terr anti&anginal medications as indicated.

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Patients with 'nstable angina have an increased risk of ac'te life& threatening dysrhythmias, which occ'r in response to ischemic changes andor stress. -lood press're may initially rise beca'se of sympathetic stim'lation, and then fall if  cardiac o'tp't is compromised.  Mental or emotional stress increases myocardial workload.  /ave patient rest for ! ho'r after meals. 4t decreases myocardial workload associated with work of digestion, red'cing risk

of angina episodes.

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4ncreases o9ygen available after myocardial 'ptake or reversal of ischemia.  ;itroglycerin has a vasodilator e