Most ischaemic heart disease is caused by atherosclerosis, usually present even when the artery lumens appear normal by angiography.
The narrowing or closure is predominantly caused by the covering of atheromatous plaques within the wall of the artery rupturing, in turn leading to a heart attack (Heart attacks caused by just artery narrowing are rare).
Nursing Diagnosis for Ischemic Heart Disease
1. Acute pain related to an imbalance of oxygen supply to myocardial demands.
2. Decreased cardiac output related to electrical factors (dysrhythmias), decrease in myocardial contraction, structural abnormalities (papillary muscular dysfunction and ventricular septal rupture)
3. Anxiety related to the needs of the body is threatened.
4. Activity intolerance related to insufficient oxygen for life activities secondary to cardiac ischemia.
Nursing Interventions for ischemic Heart Disease
1. 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
