Angina Pectoris Care Plan

Care Plan For Angina Pectoris Angina Pectoris Chief Complaint: Patient complains of having tightness and pain in his chest that seems to move down the left arm. Patient describes the pain as being sharp and can be sometimes a mild pain or an immobilizing pain. Medical Diagnosis: Coronary Artery Disease Pathophysiology of: Angina Pectoris Angina Pectoris develops when coronary blood flow becomes inadequate to meet myocardial oxygen demand. This causes myocardial cells to switch from aerobic to anaerobic metabolism, with a progressive impairment of metabolic, mechanical, and electrical functions. Angina pectoris is the most common clinical manifestation of myocardial ischemia. It is caused by chemical and mechanical stimulation of sensory afferent nerve endings in the coronary vessels and myocardium. These nerve fibers extend from the first to fourth thoracic spinal nerves, ascending via the spinal cord to the thalamus, and from there to the cerebral cortex. (http:// emedicine. medscape. com/article/15021 5-overview, 6/1 5/10 12:30 pm) Medical Interventions: Diagnostic Tests: 1. Coronary intravascular ultrasonography A coronary intravascular ultasonography is an invasive ultrasound performed rom a transducer within the lumen of the coronary arteries. (Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008). Electrocardiography is a noninvasive acoustic imaging procedure that determines the size, shape, position, thickness and movements of the heart valves, walls, and chambers during each cardiac cycle. (Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008). Lipid Profile; Blood 3. Lipid profile; blood is a test to check the units of each of the following: Total lipids, A. Triglycerides B. HDL Cholesterol C. LDL Cholesterol D. E. Total HDL Cholesterol ratio. 4. Stress Exercise Test Stress exercise test measures the efficiency of the heart during a period of physical stress on a treadmill or on a stationary bicycle. Medications: 1. Nitroglycerin Tablets: Classification: Vasodilator, antihypertensive. Action: Reduces preload and afterload, decreasing myocardial workload and oxygen demand. Uses: To prevent or treat angina pectoris, hypertension, and heart failure. Contraindications: Acute Myocardial Infarction, angle- closure glaucoma, cerebral hemorrhage, concurrent use of phosphodiesterase inhibitors, constrictive ericarditis. Route and Dosage: Adults: PO 1 mg. tablet every 5 hours while awake. (Buccal) 0. 1 To 0. 8 mg. hr. worn 12 to 14 hours at a time. (Transdermal Patch) Adverse Reactions: Some side effects of this drug that should be reported to a healthcare provider if they become severe are as follows: headaches dizziness flushing lightheadedness reported to a healthcare provider immediately. The adverse effects of nitroglycerin are: Nausea vomiting Weakness blurred vision fainting spell abdominal pain sweating chest pain pale skin rashes Ђ peeling of the skin blisters on the skin hives itching difficulty breathing Surgery: 1 Transluminal coronary angioplasty Your hearts arteries can become clogged from a buildup of cholesterol, cells or other substances. This can reduce blood flow to your heart and cause chest discomfort. Sometimes a blood clot can suddenly form or get worse and completely block blood flow, leading to a heart attack. Angioplasty opens blocked arteries and restores normal blood flow to your heart muscle. Angioplasty, a type of percutaneous coronary intervention (PCI), is not major surgery. It is done through a small puncture in a leg or arm artery and opens a clogged heart artery by inflating a tiny balloon in it. Assessment: Subjective: Patient is a 68 year old male with a history of coronary artery disease, and hypertension. Vital Signs as follows: -r: 986 R: 25 p: 102 Objective: Patient seemed to be crying and in severe pain. Skin was flushed, and clammy. Right hand was over left shoulder as if he were trying to relieve the pressure of the pain. Nursing Diagnosis: 1 Physical: 1. Acute pain related to decreased oxygen supply to the myocardium. Nursing Intervention: . Patient will remain on oxygen as ordered for the next 12 hours. 2. Give Nitroglycerin Tablets sublingually every 5 minutes for the next 1 5 minutes. . Patient will sleep for at least 30 minutes every 2 hours for the next 8 hour shift. Nursing Evaluation/Outcome: 1. Patient was able to be taken off of oxygen after the first 12 hours. 2. Patients pain had stopped after 1 5 minutes of administration of the nitroglycerin tablets. 3. Patient was able to sleep for 30 minutes every 2 hours with no interruptions in the last 8 hour shift. Nursing Diagnosis: 2 Psychosocial: 1. Anxiety related to change in lifestyle. Nursing Interventions: 1. Patient will be informed of the importance of taking the nitroglycerin at first sign of pain within an 8 hour shift. 2. Patient will learn how to decrease personal activities within 30 days. 3. Patient will Join a stress management course within the next month. 1. Patient was able to better understand the use of the nitroglycerin tablets after an 8 hour shift. 2. Patient was able to decrease physical activities in the last 30 days. 3. Patient was able to Join a stress management course in last month. Potential/ Risk: 1. Deflecient Knowledge related to coronary artery disease. . Patient will learn the causes of angina pectoris within an 8 hour shift. 2. Patient will learn the importance of side effects to medications within 8 hours. 3. Patient will make sure to get all information of medications before leaving the hospital. 1. Patient was better able to understand what caused the angina pectori by the time he left the hospital. References 1. Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008. 2. http://emedicine. medscape. com/article/1 5021 5-overview, 6/1 5/10 12:30 pm

What's your point of view Essay Example | Topics and Well Written Essays - 500 words

What's your point of view - Essay Example Video games function in a manner that an actual game in a real world is computer programmed and hardware is made, which aid in controlling the application. The world has witnessed an exponential growth of video and computer games all over the world. Almost all children in developed countries have witnessed or experienced how video games function. Instead of buying regular toys for children, parents nowadays buy their children video games since they are extremely popular (Schlimme 1). Video and computer games have many advantages. These include; improving cognitive skills in children who play these video games. Video and computer games have proved to be kits that instill motivation in children, as it is required that they play and advance to the next phase or level, which is more thrilling and interesting. Video and computer games are beneficial in the field of medicine because they are applied as part of therapy for patients with physical injuries (Medoff & Kaye 72). In physiotherapy, the games aid patients in developing motor skills and coordination. The extent to which a child or an individual concentrates when playing a game is known to relieve the child or individual’s mind from any psychological suffering or pain. Video and computer games are also educational materials as they can help in learning some math problems and language skills. Ultimately, video and computer games are main sources of psychological motivation since they put the players throug h feats, which they have to survive with the objective of moving to the next phase or level (Godara 102). As much as video and computer games are beneficial to the children and adults who play them, they have some elements, which display their detrimental nature. The great numbers of video and computer games that have themes of violence create a great havoc on the individuals who experience these games. These individuals are likely to behave in an

An Investigation into How a Student with ASD Could Use Media as a Way Case Study

An Investigation into How a Student with ASD Could Use Media as a Way to Inform Others about How This Affects his Life - Case Study Example At the end, a suitable conclusion has been rendered. The Case Daniel is a nine years old boy, who studies in the local special education school. He has been diagnosed with classical autism (a form of ASD) four years back. Daniel continuously has difficulty in making eye contact. According to the University of Wisconsin-Madison, this is a typical autistic behavior. Atypical eating habits are also a prominent symptom as has been pointed out by Filipek and his colleagues (483). Moreover, lack of social and friendly behavior is another side of the problem (Burgess and Gutstein, 80). Daniel does not prefer to be alone but he is unable to make friends. His eating habits are unusual too. Outline of Support and Related Discussion Daniel has a number of repetitive and restricted interests and activities, although his learning ability has increased through the last year. Computer assisted instruction (CAI) has been an excellent support mechanism for last one year. CAI helps in â€Å"significa nt gains in reading, phonological awareness, verbal behavior, and motivation†, as has been pointed out by the Committee of Educational Interventions for Children with Autism, National Research Council (US) (63). In school, he has lessons in SULP (Social Use of Language Problem). It uses a combination of verbal interaction in discussion format and CAI can be embedded by using audio visual media. Moreover, SEAL (Social and Emotional Aspects of Learning) is also being utilized, which is ensuring development of emotional intelligence along with IQ. According to the Committee on Educational Intervention for Children with Autism, use of frequent student to student interaction is particularly helpful in this regard (63). Further analysis and critique: The educational intervention techniques applied so far have been rather effective. The relation between the measures of instruction and the child’s performance is proportional in the sense that the intensive socialization and lin guistic intervention approach is helpful in speech and cognitive development. The SULP and SEAL involve choral responding, interaction between students, rotation of materials, and random simulation programs that are effective in teaching language and developing emotional intelligence. Particularly in SEAL, class-wide peer teaching can be helpful to foster friendship among the children and gradually help them to achieve behavioral maturity. Peer tutoring can replace traditional teaching instruction and help to achieve better results. In this context, Weiss and Delmolino further state that these practices can be adopted both at home and at school (104). Using Media to Help in Explaining ASD In this section, we will look at the option of using media in the form of a PowerPoint presentation as an effective way to help a pupil explain his ASD to others. Two questions will be discussed in this milieu: 1. What is the rationale of the intervention and how does this fit with current understa nding of ASDs? 2. To what extent does the intervention address the needs of the pupil in the areas of communication, social understanding, and flexibility of behavior? Using PowerPoint: PowerPoint is a simple MS Office software application that can be taught with relatively less complexity. PowerPoint provides a platform, where text,