Knowledge Deficit and Acute Pain - Nursing Interventions for Angina Pectoris

Angina pectoris is a clinical syndrome of chest pain due to transient myocardial ischemia. Myocardial ischemia is a condition where the heart muscle is deprived of oxygen, but has not suffered damage and is reversible, which is the diagnostic tool ECG showed ST depression or T inversion.

Based on clinical symptoms, Angina pectoris divided into two stable angina pectoris and unstable angina pectoris. Stable angina pectoris is a chest pain incident lasted no more than 15 minutes, the originators is a physical activity or trigger factors such as stress. Chest pain can be relieved by rest or medication (sublingual nitroglycerin). Unstable angina pectoris is chest pain incident lasted more than 15 minutes with intensity and increasing frequency whenever recurrence. Lighter trigger factors, can occur at rest. Were classified as unstable angina pectoris that patients with angina in the last 2 months felt increasingly burdensome with frequency quite often (can occur 3 times a day), patients with angina that is increasing rapidly, but the lighter trigger factors, patients with angina attacks at rest.

Characteristics of chest pain in angina pectoris can be used as a benchmark based on the location of pain, pain quality, quantity pain, accompanying symptoms. Location of pain can be found in the middle of the chest, retrosternal or substernal or pericardial area, which can be accompanied by radiation to the neck, jaw, shoulder, down to the arm (usually the left arm). The quality of pain may be dull pain like the taste crushed, or heaviness in the chest area, a strong sense of urgency, a sense of pressure. Pain associated with activity and reduced or cured by rest, therapy was not associated with changes in the movement of the breath and body position changes. Quantity pain lasting, pain is usually intermittent with increasing intensity or reduced or controlled. Pain that occurs continuously throughout the day or even a few days is usually not painful angina pectoris. Other symptoms that may accompany angina pectoris include nausea, vomiting, sweating, difficulty breathing, anxiety, and fatigue.


Nursing Diagnosis for Angina Pectoris : Knowledge Deficit (learning need) regarding Events, treatment needs related to lack of information.

Intervention:

1. Emphasize the need to prevent angina attacks.
2. Instruct to avoid the factors / situations as the originator of angina episodes.
3. Assess the importance of weight control, smoking cessation, dietary changes and exercise.
4. Show / encourage clients to monitor their own pulse during activity, avoid stress.
5. Discuss the steps taken in the event of an attack of angina.
6. Encourage clients to follow the specified program.

Nursing Diagnosis for Angina Pectoris : Acute Pain related to myocardial ischemia.

Intervention:

1. Assess the factors that aggravate the pain.
2. Advise for a complete rest during episodes of angina (first 24-30 hours) with a semi-Fowler position.
3. Observation of vital signs every 5 minutes every attack of angina.
4. Create a quiet environment, limit the visitor when necessary.
5. Give soft foods and let clients break 1 hour after meals.
6. Staying with clients who are experiencing pain or looking worried.
7. Teach distraction and relaxation techniques.
8. Collaboration treatment.