Question

Refer the previous question: The following table gives the common disorders, problems and complaints associated with each body system and its components relevant to the nursing care you might provide for your clients in the Australian health care system. Complete the following table with regard to its definition, pathophysiology, signs and impact of specific health procedures(in 10-20 words each). DISEASES AFFECTING THE CARDIOVASCULAR SYSTEM Angina pectoris Angina pectoris 11.1) Definition 11.2) Briefly outline the pathophysiology 11.3) List four specific signs 11.4) Impact of supplimental oxygen therapy in patients with angina

Answer 1

Angina pectoris:

Definition:

Angina pectoris is a chest pain due to an inadequate supply of oxygen to the heart muscle..The pain is typically severe and crushing,and it is charectetized by a feeling of pressure and suffocation just behind the breast bone..Angina can accompany with heart attack..

Pathophysiology:

It is commonly caused by myocardial ischemia which results from demand myocardial blood flow and oxygen demand..because of decreased blood flow there will be atherosclerotic narrowing of an epicardial coronary artery,though abnormal vasodilation or vasodilation constriction result from impaired endothelial function..so myocardium become ischemic (pain), coronary sinus blood PH falls,cellular potassium is lost,lactate accumulates,ECG abnormalities appear,both systolic and diastolic level alter..left ventricular diastolic pressure usually increases during angina,it can induce pulmonary congestion and dyspnea..

Signs:

Chest pain,pain in the arms,neck,jaw,shoulder or back, indigestion or heart burn,shotness of breath, nausea

Supplemental oxygen therepy:

Administration of 100% oxygen actually contraindicated in patients with myocardial infarction or angina pectoris if oxygen saturation is normal..To hypothesis that hyperoxygenated blood may interfere with the reactive hyperemia which accompanies an ischeimic myocardium..but unproven research told High flow oxygen important for arterial hypoxia..so it can increase the oxygen supply to the myocardium and reduce the size of infarct..in the first few days following myocardial infarction or angina pectoris administration of 40% oxygen for 20 minutes results low cardiac output and high arterial blood pressure..

Recent studies have shown concern around the efficacy and safety of supplemental oxygen in normoxaemic patients..To synthesis the evidence from randomised controlled trial (RCTs) investigated the effects of supplemental oxygen therapy compared with room air in patients with suspected acute myocardial infarction..outcomes of interests included mortality,troponin levels,infarct size,pain and hypoxemia..7998 participants in that 3982 in O2 4002 in room air..In hospital or 30_ day death occurred in 135 and 149 patients.. oxygen therapy did not reduce the risk of in hospital or 30_day mortality in AMI.. infarct size in a subgroup was not different between with out oxygen therapy..oxygen therapy reduced the risk of hypoxemia..

So supplemental oxygen therapy is commonly used,it was not related with important clinical benefits..eight RCTs reported with support the usual practice of administering oxygen in normoxaemic patients..