Angina Dx

[JillFRN]

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

[Daytonite, BSN, RN]

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 :redbeathe
  
  • heart rate - beats per minute
    
  • stroke volume - amount of blood pumped per beat
    

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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.
     

[*]activity intolerance r/t imbalance between o2 supply and demand

[*]disturbed sleep pattern r/t excessive stimulation noise, lighting

[*]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
  

[*]deficient knowledge r/t condition of angina

• should be written: deficient knowledge, angina r/t lack of information
  

[*]anxiety r/t unknown dx, change in health status

[JillFRN]

Thanks so much!!