Angina Dx

  1. I had a pt with Angina and possibly MVP, but it was unsure at that point and for my careplan I need to have 6 Dx. Here are what I came up with and they need to be in order. My professor gave me the first one and I always thought Risk would be towards the bottom, but she said it was first. Any input is appreciated

    1) Risk for Decreased Cardiac output R/T Heart Valve Dysfunction
    2) Acute Pain R/T Decreased Myocardial Blood Flow
    3) Activity Intolerance R/T Imbalance between O2 supply and demand
    4) Anxiety R/T unknown dx, change in health status
    5) Deficient knowledge R/T condition of angina
    6) Disturbed sleep pattern R/T excessive stimulation noise, lighting
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    About JillFRN

    Joined: Apr '07; Posts: 77; Likes: 11
    Registered Nurse


  3. by   Daytonite
    if she told you to put that first, then do it. however, if the patient already has pain because the heart cells aren't getting enough oxygen that is a low cardiac output right there (low stroke volume). people get angina because they are not getting enough oxygen pumped to the cells of their heart and that is a failure of the cardiac output.
    • components of cardiac output
      • heart rate - beats per minute
      • stroke volume - amount of blood pumped per beat
    1. risk for decreased cardiac output r/t heart valve dysfunction
      • the "heart valve dysfunction" refers to the possible mvp which if it did exist would affect the stroke volume which in turn affects cardiac output. still i disagree that it deserves top billing.
    2. activity intolerance r/t imbalance between o2 supply and demand
    3. disturbed sleep pattern r/t excessive stimulation noise, lighting
    4. acute pain r/t decreased myocardial blood flow
      • should be written: acute pain r/t decreased myocardial oxygenation - the cause of the pain is not enough oxygen getting to the heart cells
    5. deficient knowledge r/t condition of angina
      • should be written: deficient knowledge, angina r/t lack of information
    6. anxiety r/t unknown dx, change in health status
  4. by   JillFRN
    Thanks so much!!