help with coronary artery disease/stable angina patient

  1. 0
    Hi there,

    This is my first time posting here so my apologies if I have posted in the wrong section.
    I need help with a report I have to do for uni and this is my first care plan I am doing so I am extremely confused to say the least so bare with me because I have quite a few questions .

    Firstly my patient presented to hospital with left sided chest pain and has never experienced this before. They have been diagnosed with coronary artery disease and stable angina in addition they are a smoker, inactive and obese and have other co-morbidities such as type 2 diabetes, HT and high cholesterol.

    There was no myocardial infarction and no surgical procedure needed. So my question is what are the clinical interventions that would be undertaken to treat this patient other than medications. In addition what are some of the diagnostics test that would be conducted such as an ECG etc. I also know about lipid testing but I do not actually know the official name of that type of test and how it is conducted?

    And finally what could be possible nursing diagnses so far i have;
    decreased cardiac output, more than body requirements and ineffective health management.

    and on admission is it correct that the only focused assessments that would have been conducted are a cardiovascular, respiratory and endocrine assessment based on the clients reason for admission or am I missing something.

    I know this is alot but I would really appreciate your help. Thank you in advanced !!!!
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  3. 4 Comments so far...

  4. 0
    I'm not current on careplans, but I'm not sure on the info you've given, that the patient has decreased cardiac output. What about comfort/pain, decreased exercise tolerance, nutrition imbalance, respiratory impairment r/t smoking cessation.
    If the pt. didn't have a heart cath, they will need a stress test and probably an echo. Labs will include a fasting lipid panel, cbc, metabolic panel and and maybe a HbA1C. They will need nutritional counseling, dm teaching prn, smoking cessation help, and and exercise guidelines, if cleared.
    As for admission assessment, a complete assessment needs to be conducted for an accurate diagnosis--we get many a r/o MI who have GERD or cholelithiasis, PE, pulm. HTN, pneumonia, etc.
  5. 0
    Let me move this to the student nursing assistance forum.
  6. 0
    I would also look at ineffective cardiac tissue perfusion as a nursing diagnosis
  7. 0
    Other tests:

    * cardiac enzymes
    * hs-CRP (C-reactive protein): If elevated, indicate coronary artery plaques are inflammatory
    * BNP (B-type ["brain"] natriuretic peptide): elevated in HF.
    * CBC: may provide useful information regarding possible anemia or infection/inflammation. May be used to r/o other diagnoses that can cause chest pain.
    * serum electrolytes
    * coag studies
    * stress test
    * thallium treadmill stress test
    * Serum lipid tests: total cholesterol test, triglyceride analysis

    Nursing diagnoses: pain, decreased CO (or risk for), activity intolerance, knowledge deficit: disease process and its lifestyle implications


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