Angina V: Nursing Management

Common nursing diagnoses include acute pain related to myocardial ischemia, evidenced by chest pain and diaphoresis, and decreased cardiac output related to altered electrical conduction, shown by dysrhythmias and hypotension. Activity intolerance and knowledge deficit regarding angina management are also important diagnoses to address during comprehensive nursing care.

Nurses should position angina patients in a semi-Fowler's position, which aids in reducing myocardial oxygen demand and promotes comfort. This positioning, combined with rest, helps minimize chest pain and pressure while improving respiratory function and reducing the workload on the heart.

Supplemental oxygen should be provided when oxygen saturation drops below 90% or when the patient experiences dyspnea. Oxygen therapy helps improve tissue perfusion and reduces myocardial ischemia by increasing oxygen availability to the heart muscle during episodes of decreased cardiac output.

Objective assessment findings include tachycardia, elevated blood pressure, abnormal ECG changes such as ST-segment depression or T-wave inversion, pallor, cool extremities, and oxygen desaturation. These clinical indicators help nurses identify reduced cardiac output and guide appropriate interventions for patient stabilization.

Prescribed medications include nitroglycerin for immediate pain relief, antiplatelet agents like aspirin to reduce clot formation, beta-blockers to lower myocardial workload, and statins to manage dyslipidemia. Calcium channel blockers or nitrates may also be used to improve coronary perfusion and prevent ischemic episodes.

Nurses continuously monitor vital signs, track serial ECG changes, and assess cardiac enzyme levels such as troponin and CK-MB to identify ischemic changes or myocardial damage. Regular monitoring enables timely detection of complications and guides adjustments to the nursing care plan.

Primary goals include pain relief, stabilization of vital signs, prevention of complications like myocardial infarction, and promotion of long-term adherence to therapeutic regimens. Patient education on symptom recognition, trigger management, and lifestyle modifications is essential to reduce recurrence and improve quality of life.