Nursing management
- Nursing Assessment:
- Subjective Data
- Health history
- CAD/chest pain/angina/ MI
- Valve disease
- Heart failure/cardiomyopathy,
- Hypertension, diabetes, anemia, lung disease, hyperlipidemia
- Drugs
- Use of anti-platelets or anticoagulants
- Nitrates
- Angiotensin-converting enzyme inhibitors
- β-blockers
- Calcium channel blockers
- Antihypertensive drugs
- Lipid-lowering drugs
- Over-the-counter drugs (e.g., vitamin and herbal supplements)
- History of present illness
- Description of events related to current illness
- Health perception–health management:
- Family history of heart disease.
- Sedentary lifestyle
- Tobacco use
- Exposure to environmental smoke
- Nutritional-metabolic
- Indigestion/heartburn; nausea/vomiting
- Elimination
- Urinary urgency or frequency
- Straining at stool
- Activity-exercise
- Palpitations, dyspnea, dizziness, weakness
- Cognitive-perceptual
- Substernal chest pain or pressure (squeezing, constricting, aching, sharp, tingling)
- Possible radiation to jaw, neck, shoulders, back, or arms
- Cognitive-stress tolerance
- Stress, depression, anger, anxiety
- Health history
- Objective Data
- Anxious, fearful, restless, distressed
- Integumentary effects
- Cool, clammy, pale skin
- Cardiovascular
- Tachycardia or bradycardia
- Pulsus alternans
- Pulse deficit
- Dysrhythmias
- S3, S4, increased or decreased BP, murmur
- Possible diagnostic findings
- Positive serum cardiac biomarkers
- Increased serum lipids;
- Increased WBC count.
- Positive exercise or pharmacologic stress test and thallium scans.
- Pathologic Q wave, ST segment elevation, and/or T wave abnormalities on ECG.
- Cardiac enlargement, calcifications, or pulmonary congestion on chest x-ray.
- Abnormal wall motion with stress echocardiogram.
- Positive coronary angiography
- Subjective Data
