Question

Give and explain 5 intervention for coronary artery disease.

Answer 1

Coronary artery disease ( CAD) characterized by the accumulation of plaque within coronary arteries, which progressively enlarge, thicken and calcify. This causes critical narrowing of the coronary artery lumen (75% occlusion), resulting in a decrease in coronary blood flow and an inadequate supply of oxygen to the heart muscle.

Primary nursing diagnosis

• Altered tissue perfusion (myocardial) related to narrowing of the coronary artery(ies) associated with atherosclerosis, spasm, and/or thrombosis

Other Diagnoses that may occur in Nursing Care Plans For CAD

• Acute pain
• Risk for decreased cardiac output
• Anxiety
• Deficient knowledge (Learning Need) regarding condition, treatment plan, self-care, and discharge needs.

  Nursing Intervention

• Monitor blood pressure, apical heart rate, and respirations every 5 minutes during an anginal attack.
• Maintain continuous ECG monitoring or obtain a 12-lead ECG, as directed, monitor for arrhythmias and ST elevation.
• Place patient in comfortable position and administer oxygen, if prescribed, to enhance myocardial oxygen supply.
• Identify specific activities patient may engage in that are below the level at which anginal pain occurs.
• Reinforce the importance of notifying nursing staff whenever angina pain is experienced.
• Encourage supine position for dizziness caused by antianginals.
• Be alert to adverse reaction related to abrupt discontinuation of beta-adrenergic blocker and calcium channel blocker therapy. These drug must be tapered to prevent a “rebound phenomenon”; tachycardia, increase in chest pain, and hypertension.
• Explain to the patient the importance of anxiety reduction to assist to control angina.
• Teach the patient relaxation techniques.
• Review specific factors that affect CAD development and progression; highlight those risk factors that can be modified and controlled to reduce the risk.

• Documentation Guidelines

• Episodes of angina describing character, location, and severity of pain; precipitating or mitigating factors; interventions; and evaluation
• Patient teaching about disease process and planned treatments, including medication regimen
• Perioperative hemodynamic response: Pulmonary and systemic arterial pressures, presence of pulses, capillary refill, urine output
• Pulmonary assessment: Breath sounds, ventilator settings, response to mechanical ventilation, secretions
• Complications: Bleeding, blood gas alterations, fluid volume deficit, hypotension, dysrhythmias, hypothermia
• Coping: Patient and family
• Mediastinal drainage and auto transfusion.