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Angina Pectoris

Ch. 29 Lemone

QuestionAnswer
Angina Pectoris Chest pain resulting from reduced coronary blood flow causing a temporary imbalnced between myocardial blood supply and demand.
Angina Pectoris Due to CHD, atherosclerosis or vessel constriction that impairs blood supply to myocardium
Angina Pectoris Precipitating Factors Hypermetabolic : Excercise, Thyotoxicosis, hyperthyroidism, stimulant abuse, emotional stress. Factors affecting blood and oxygen supples: anemia, heart failure, pulmonary disease
Angina Pectoris (Angina) Pathophysiology Temporary or reversible myocardial ischemia, Cells in region supplied by artery are deprived, cells switch to anaerobic metabolism causing lactic acid, cell membrane release histamine, kinins specific enzymes, pain radiates to upper body heart shares derm
Angina pathophysiology p.2 return of adequate circulation provides nutrients and clears away products, > 30 min. of ischemia irreversible damages
Types of Angina Stable Angina, Prinzmetals Angina, Unstable angina, silent Myocardial Ischemia
Stable Angina Predicatable angina, common manifestation of CHD, Occurs when work of heart is increased by physical exertion
Prinzmetals Angina Atypical angina occurs unpredicatable, caused by spasm of coronary artery, exact cause unknown
Unstable Angina Occurs with increasing frequency, severity, duration, Pain is unpredictable, Risk for MI
Silent Angina Asymptomatic ishemia, thought to be common with CHD occurs with activity or mental stress
Angina Manifestations Chest Pain, tight squeezing pain, heavy pressure, constricting sensation, pain to jaw, epigastric region or back.Dypnea, pallor, tachycardia, fear Pain lasts < 15 min.
Angina Sequence Activity , Pain, Rest, Relief
Angina Collaborative Care Pain Relief, Restoration of coronary blood flow
Angina Diagnostic Tests Past Medical Hx and Family Hx, Descrip. of pain, Lab tests, Diagnostic Tests, overall cardiac function, Electrocardiagraphy, Stress electrocardiography, Radionuclide testing, Echocardiography, Coronary Angiography, Medications, Revascularazation Procedure
Angina Medications Nitrates, Beta Blockers, Calcium Channel Blockers,
Angina Nursing Diagnoses ineffective Tissue Perfusion: Cardiac, 2. Risk for Ineffective Therapeutic Regimen Mgmt.
Angina Medication Administration Nitroglycerin, Isosorbide dinatrate, Isosbride Mononitrate Amyl nitrite
Nitrates dilate both arterial and venous vessels, depending on the dose.Vasodilation increases blood flow and oxygen supply
Med. Admin Nursing Responsibilities Dilute intravenous nitroglycerin before infusing: use only glass bottles for mixture, Wear gloves when apping nitroglycerin patches.
Med Adm. Client and Family Teaching Nitrates Use only sublingual, buccal and spray forms of ntirates, 5 min. inbetween doses, Carry tablets with you at all times, keep tables in amber glass bottle, may experience headache or tingling, caution when standing, rotate patch placement
Angina Med. Adm. Beta Blokers Propranol (Inderal), Nadolo (Corgad) Beta blockers decrease cardiac worklaod by blocking beta receptors
Med. Adm Beta Blocker Nursing Responsibilities Document heart rate and BP before administering, Assess for and report possible contraindications to therapy including heart failure, bradycardia, av block asthma and COPD, Do not abruptly discontinue these drugs.
Med. Adm. Client and Family Teaching Beta Blockers Beta blockers help prevent angina but will not relieve an acute attack. Keep fast acting available, Do not stop taking medication, Take your pulse daily. Do not take if it is below 50 beats per minute. Report a slow or irregular pulse
Med. Adm. Calcium Channel Blockers Nifedipine, Diltiazem, Verpamil, Bepridil, Felodipine, Isradipine, Nicardipine, Nipmodipine Calcium Channel blockers are used to control angina, hypertension and dysrhythmias.
Nursing Responsiblities Calcium Channel Blockers Do not mix verapamil in any solution contianing sodium bicarbonate. IV push over 2 to 3 min., Doc blood pressure and HR before administering the drug.the nifedipine capsule may be punctured and administered by extracting the liquid w/ syringe, Use cautiom
Nursing Respon. Calcium Channel Blocker P. 2 Manifestations of toxicity include nausea, generalized weakness, signs of decreased cardiac output, hypotension, bradycardia, and AV block
Client and Family Teaching Calcium Channel Blocker Take your pluse before taking the drug. Keep a fresh supply of immediate acting nitrate available to treat acute anginal attacks.
Created by: Daverica
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