Nursing care plans cardiac complaints

it helpful for the nursing students while writing care plan. if you like the give your comment and share to others

1. NURSING CARE PLAN CARDIOVASCULAR SYSTEM

2. NURSING ASSESSMENT Ask patient to describe anginal attacks. When do attacks tend to occur? After a meal? After engaging in certain activities? After physical activities in general? After visits of family/others? Where is the pain located? Does it radiate? Was the onset of pain sudden? Gradual? How long did it last seconds ? Minutes? Hours? Was the pain steady and unwavering in quality? Is the discomfort accompanied by other symptoms? Sweating? Light-headedness? Nausea? Palpitations? Shortness of breath? How is the pain relieved? How long does it take for pain relief?

3. Obtain a baseline 12-lead ECG. Assess patient's and family's knowledge of disease. Identify patient's and family's level of anxiety and use of appropriate coping mechanisms. Gather information about the patient's cardiac risk factors. Use the patient's age, total cholesterol level, HDL level, systolic BP, and smoking status to determine the patient's 10-year risk for development of CHD according to the Framingham risk scoring method (Third Report of the National Cholesterol Education Program

4. Evaluate patient's medical history for such conditions as diabetes, heart failure, previous MI, or obstructive lung disease that may influence choice of drug therapy . Identify factors that may contribute to noncompliance with prescribed drug therapy. Review renal and hepatic studies and complete blood count. Discuss with patient current activity levels. (Effectiveness of antianginal drug therapy is evaluated by patient's ability to attain higher activity levels.) Discuss patient's beliefs about modification of risk factors and willingness to change.

5. Nursing Diagnoses 1. Acute Pain related to an imbalance in oxygen supply and demand 2. Decreased Cardiac Output related to reduced preload, afterload , contractility, and heart rate secondary to hemodynamic effects of drug therapy 3. Anxiety related to chest pain, uncertain prognosis, and threatening environment .

6. Conti.. 4. Acute Pain related to oxygen supply and demand imbalance 5. Anxiety related to chest pain, fear of death, threatening environment 6. Activity Intolerance related to insufficient oxygenation to perform activities of daily living, deconditioning effects of bed rest 7. Risk for Injury (bleeding) related to dissolution of protective

7. Nursing Diagnosis Impaired Gas Exchange related to pulmonary congestion due to elevated left ventricular pressures Ineffective Tissue Perfusion (renal, cerebral, cardiopulmonary, GI, and peripheral) related to decreased blood flow

8. ASSESSMENT NURSING DIAGNOSIS GOAL / EXPECTED OUTCOME INTERVENTION / PLANNING IMPLEMENTATION RATIONAL EVALUATION Subjective data – patient says that “I have chest pain, breathing problem” Acute Pain related to an imbalance in oxygen supply and demand Short term goal = Relieving Pain Long term goals = To improve oxygenation Assess general condition of patient Assessment is done To know the baseline data and for patients cooperation Verbalizes relief of pain. Oxygen saturation is 98 % Position patient for comfort Fowlers position given to patients Fowler's position promotes ventilation. Administer oxygen Oxygen provided to the patients To fulfill the need of oxygen Objective data= restlessness, tiredness while walking, & anxiety . Provide diversionsional therapy Diversional therapy provided that is music To divert the mind Check vital signs of patient Vitals checked every two hourly To know the normal values of vitals Obtain a 12-lead ECG as directed ECG taken To know the cardiac changes of the patient Administer antianginal drug as prescribed Antianginal drugs administered to reduce pain intensity

9. ASSESSMENT NURSING DIAGNOSIS GOAL / EXPECTED OUTCOME INTERVENTION / PLANNING IMPLEMENTATION RATIONAL EVALUATION Subjective data – Patient says that I have irregular breath Decreased Cardiac Output related to reduced preload, afterload , contractility, and heart rate secondary to hemodynamic effects of drug therapy Short Term Goal- Maintaining Cardiac Output Assess general condition of patient Assessment is done To know the baseline data and for patients cooperation Blood pressure and heart rate stable Carefully monitor the patient's response to drug therapy . Patient is under the observation To know the side effects as early as possible Monitor ECG continuously Continuously ECG monitored To know the cardiac changes Report adverse drug effects to health care provider. All report given to doctor To take immediate action on plan Objective data- vitals are unstable Long Term Goal- To stable vitals Teach slow, pursed-lip breathing Breathing exercises taught To reduce airway obstruction. Administer I.V. Fluids as per doctors order Administered intravenous fluids To maintained cardiac volume Transfuse blood if required 1 bag blood is given as per doctors order It helps to maintain the cardiac output level Maintain intake and output of the patient Intake and output is maintained To know the cardiac output of the patient

10. ASSESSMENT NURSING DIAGNOSIS GOAL / EXPECTED OUTCOME INTERVENTION / PLANNING IMPLEMENTATION RATIONAL EVALUATION Subjective data - Anxiety related to chest pain, uncertain prognosis, and threatening environment. Short term goal – to reduce anxiety level Assess general condition of patient Assessment is done To know the baseline data and for patients cooperation Pain is reducing as per verbalization of patient and patient knows importance to reduce anxiety Allow patient to ask the questions Patient is asking questions regarding disease condition It helps to relieve the anxiety Encourage patient to verbalize fear and concern. Patients asking their doubts to staff and dr. It helps to reduce fear. Objective data - Check vital signs regularly Vitals are stable To know the changes in patient condition Long term goal – to reduce pain Administer medication Administered antianxinal medication. It helps to relieve from anxiety. Explain patient about importance to reduce anxiety. Educate the patient about anxiety To aware about its importance

11. Thank you