Ischemic Heart Disease (IHD) also known as Coronary artery disease (CAD), atherosclerotic heart disease, atherosclerotic cardiovascular disease, coronary heart disease is the most common type of heart disease and cause of heart attacks. The disease is caused by plaque building up along the inner walls of the arteries of the heart, which narrows the arteries and reduces blood flow to the heart.
Unstable IHD presents itself as chest pain or other symptoms at rest, or rapidly worsening angina. The risk of artery narrowing increases with age, smoking, high blood cholesterol, diabetes, high blood pressure, and is more common in men and those who have close relatives with CAD. Other causes include coronary vasospasm, a spasm of the blood vessels of the heart, it is usually called Prinzmetal's angina.
Diagnosis of IHD is with an electrocardiogram, blood tests (cardiac markers), cardiac stress testing or a coronary angiogram. Depending on the symptoms and risk, treatment may be with medication, percutaneous coronary intervention (angioplasty) or coronary artery bypass surgery (CABG).
Nursing Diagnosis and Interventions for Ischaemic Heart Disease
Nursing Diagnosis : Decreased cardiac output related to electrical factors (dysrhythmias), Decrease in myocardial contraction, structural abnormalities (papillary muscular dysfunction and ventricular septal rupture)
Outcome: The patient will demonstrate a stable cardiac condition or better.
Intervention:
Nursing Diagnosis : Acute pain related to an imbalance of oxygen supply to myocardial demands.
Outcome: The patient will express pain decreased
Intervention:
Nursing Diagnosis : Anxiety related to the needs of the body is Threatened.
Objectives: The patient will demonstrate reduced anxiety after nursing actions.
Intervention:
Unstable IHD presents itself as chest pain or other symptoms at rest, or rapidly worsening angina. The risk of artery narrowing increases with age, smoking, high blood cholesterol, diabetes, high blood pressure, and is more common in men and those who have close relatives with CAD. Other causes include coronary vasospasm, a spasm of the blood vessels of the heart, it is usually called Prinzmetal's angina.
Diagnosis of IHD is with an electrocardiogram, blood tests (cardiac markers), cardiac stress testing or a coronary angiogram. Depending on the symptoms and risk, treatment may be with medication, percutaneous coronary intervention (angioplasty) or coronary artery bypass surgery (CABG).
Nursing Diagnosis and Interventions for Ischaemic Heart Disease
Nursing Diagnosis : Decreased cardiac output related to electrical factors (dysrhythmias), Decrease in myocardial contraction, structural abnormalities (papillary muscular dysfunction and ventricular septal rupture)
Outcome: The patient will demonstrate a stable cardiac condition or better.
Intervention:
- Maintain bed rest with head elevation of 30 degrees during the first 24-48 hours.
- Assess and monitor vital signs and hemodynamic per 1-2 hours.
- Monitor and record ECG continue to assess the rate, rhythm, and order to each change per 2 or 4 hours.
- Review and report signs of CO reduction.
Nursing Diagnosis : Acute pain related to an imbalance of oxygen supply to myocardial demands.
Outcome: The patient will express pain decreased
Intervention:
- Assess pain location, duration, radiation, occurrence, a new phenomenon.
- Review of previous activities that cause chest pain.
- Create a 12 lead ECG during anginal pain episodes.
- Assess signs of hypoxemia, give oxygen therapy if necessary.
- Give analgesics as directed.
- Maintain a rest for 24-30 hours during episodes of illness
- Check vital signs, during periods of illness.
Nursing Diagnosis : Anxiety related to the needs of the body is Threatened.
Objectives: The patient will demonstrate reduced anxiety after nursing actions.
Intervention:
- Assess signs and verbal expressions of anxiety
- Take action to reduce anxiety by creating a calm environment
- Accompany patient during periods of high anxiety
- Provide an explanation of procedures and treatments
- Encourage patients to express feelings
- Refer to the spiritual adviser if necessary
