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.
2. 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.
3. 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
Source : http://nursingdiagnosis-nursinginterventions.blogspot.com/2012/03/nursing-diagnosis-and-interventions-for.html
