Investigating the Relevance of Nursing Caring Interventions Delivered to Patients with Coronary Artery Disease at a Teaching Hospital in China: A Retrospective Study. Coronary artery disease starts when there is injury or damage to the inner layer of coronary arteries. Coronary heart disease (CHD) is one of the leading causes of morbidity and mortality worldwide [1]. Desired outcome: The patient will be able to maintain adequate cardiac output.
11th Edition, Mariann M. Harding, RN, PhD, FAADN, CNE. These data have implications for clinical nursing of CHD patients, suggesting CNISD may help patients with CHD avoid a high risk of recurrence and mortality. Acute Pain Interventions. The CNISD project included usual care, the most common complications or adverse events in the care of CHD patients, enhanced preoperative care, enhanced post-operative care and discharge health guidance for all CHD patients based on self-disclosure. Other sensations include a squeezing, aching, burning, choking, strangling, or cramping pain. The following drugs may be used to treat coronary artery disease, as well as the accompanying chest pain (angina): Blood thinning agents such as Aspirin – to reduce the ability of the blood to clot, so that the blood flows easier through the narrowed arteries. A previous study provided an experimental basis for the clinical application of comprehensive nursing intervention in CHD patients [22]. Acute Pain Care Plan. Assess and monitor vital signs. Medical-surgical nursing: Concepts for interprofessional collaborative care. The patient will demonstrate two effective relaxation strategies. Poor sleep quality predicts decline in physical health functioning in patients with coronary heart disease and moderating role of social support. Risk for decreased cardiac output.
Chest pain is provoked by exertion or stress and is relieved by nitroglycerin and rest. Rationale: Desired effect is to decrease myocardial oxygen demand by decreasing ventricular stress. Patient Self-Efficacy Scores. To continue reading this clinical article please log in or subscribe. Rationale: Angina is a symptom of progressive coronary artery disease that should be monitored and may require occasional adjustment of treatment regimen. Physical activity of CHD patients was accessed using The ActiGraph GT3X + (ActiGraph, Pensacola, Florida, VS) and analyzed using the ActiGraph software (Version ActiLife 6. When there is insufficient blood and oxygen supply (ischemia) to the myocardium, decreased tissue perfusion and necrosis (infarction) will develop, requiring immediate intervention. Alterations in rate/rhythm and electrical conduction. Assist patient and/or SO to identify sources of physical and emotional stress and discuss ways that they can be avoided. Acute coronary syndrome is a complication of CAD due to lack of oxygen to the myocardium. Risk factor for Coronary Artery Disease include dyslipidemia, smoking, hypertension, male gender (women are protected until menopause), aging, non-white race, family history, obesity, sedimentary lifestyle, diabetes mellitus, metabolic syndrome, elevated homocysteine, and stress. Be certain that the patient and appropriate family members understand all medications, including the correct dosage, route, action, and adverse effects. 842, which indicated a good internal consistency reliability between two groups.
Rationale: Angioplasty (also called percutaneous transluminal coronary angioplasty [PTCA]) increases coronary blood flow by compression of atheromatous lesions and dilation of the vessel lumen in an occluded coronary artery. According to China's fifth health service survey in 2013, the number of CHD patients over 15 years old in China exceeded 10 million [2], and China's Health and Family Planning Statistical Yearbook (2016) confirmed that the number was still on the rise. Consent for publication. Inaccurate follow-through of instructions. Conflicts of Interest. Notably, CNISD markedly improved anxiety and depression of CHD patients compared to usual care (Table 2, Cronbach's alpha was 0. When, the differences were statistically significant.
The 13th Five-Year Nursing Development Plan proposes to improve the contents and methods of nursing services with specialist nurses as the carrier and provide community residents with preventive knowledge on common diseases and early rehabilitation of chronic diseases and home care services so as to enhance the nursing compliance of patients with chronic diseases after discharge [23]. Rationale: Prolonged chest pain with decreased cardiac output reflects development of complications requiring more emergency interventions. ④ The diseases such as hypertension and hyperlipidemia, the predisposing factors of CHD, were closely related to the daily living habits of patients. Assess your knowledge and gain CPD evidence by taking the Nursing Times Self-assessment test. The reference group included 30 males and 30 females with an average age of 66. Modifying lifestyle: - How to manage with diet (low fat, low calorie). Zhang J, Guo Q, Peng L, Li J, Gao Y, Yan B, Fang B, Wang G. The association of neck circumference with incident congestive heart failure and coronary heart disease mortality in a community-based population with or without sleep-disordered breathing. Mostafavian Z, Vakilian F, Torkmanzade L, Moghiman T. Effect of stem cell therapy on patients' quality of life in heart failure with reduced ejection fraction.
The management of CAD involves modifying risk factors to prevent and slow disease progression. View of self as noncontributing member of family/society. Discuss pathophysiology of condition. The main characteristics of CHD patients are summarized in Table 1. 2018;131(12):1499-1505 e1492. If not relieved in 5 minutes take another one for a 3rd dose. Note: Often these drugs alone are sufficient to relieve angina in less severe conditions. 50 clinical subjects and 20 clinical roles or settings. Discuss impact of illness on desired lifestyle and activities, including work, driving, sexual activity, and hobbies. Encourage the patient to maintain the prescribed diet. Coronary Artery Disease Nursing Care Plan 5. Measure cardiac output and other functional parameters as indicated. RN, BSN, PHN Clinical Nurse Instructor. Surgical interventions are required if the medical team believes that an urgent, more aggressive treatment for CAD is needed.
Provide information, privacy, or consultation, as indicated. Crackles in the lungs can occur with cardiac decompensation. Other Diagnoses that may occur in Nursing Care Plans For CAD. Authors: Selina Jarvis is research nurse and former Mary Seacole development scholar, Kingâs College Hospital Foundation Trust; Selva Saman is consultant, Port Shepstone Regional Hospital, Port Shepstone, South Africa. Coronary Artery DiseasePractice Quiz 5 Questions with Rationales – Randomized. Khan H, Kella D, Kunutsor SK, Savonen K, Laukkanen JA. Diagnostic Evaluation. Independent samples t-test was used for intergroup comparisons. This is an NCLEX review for coronary artery disease. Elevate head of bed if patient is short of breath. She found a passion in the ER and has stayed in this department for 30 years.
When cardiac output is compromised, peripheral circulation is reduced, manifesting as pallor, cyanosis, and diminished peripheral pulses. During surgery, the patients' physical sign data were closely monitored, and the appropriate temperature and humidity of the operating room were ensured to prevent their body temperature from decreasing. Patients have different degrees of lumen occlusion and stenosis, resulting in myocardial ischemia, hypoxia, and necrosis, with the main clinical manifestations as chest pain (paroxysmal colic or crush pain) and chest distress [1]. 516, ), higher scores of self-management ability, and a lower incidence of postoperative complications. The pain may radiate to the neck, shoulder, back, arm., or jaw. Transmyocardial revascularization. Lewis's Medical-Surgical Nursing. Table 4 showed that the number of satisfied CHD patients in CNISD group was higher than those patients in usual care group.
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