Care Plan for Managing Angina

Care Plan for Managing Angina

Category / Primary Body System

• Cardiovascular System

Problem

• Resident has angina.

Goal

• Resident will not have chest pain for the next 90 days.

Plan/Approach

1. Monitoring and Assessment

   • Monitor every shift for chest pain, documenting any episodes.
   • Perform a full cardiac assessment with any onset of chest pain, including blood pressure (BP), apical pulse (AP), radial pulse, oxygen saturation, bilateral breath sounds (BLBS), respiration rate, and location of pain.

2. Medication Management

   • Administer Nitroglycerin (NTG) as directed, monitoring for signs of NTG side effects such as palpitations, headache, hypotension, weakness, dizziness, nausea/vomiting (NV), dry mouth, blurred vision, and pallor.
   • Check blood pressure between each dose of NTG to ensure the patient can tolerate the next dose. If BP drops to < 90/50, hold the next dose and inform the MD immediately.
   • Report to the MD immediately if chest pain is not relieved after three NTG tablets.
   • Instruct the patient to let NTG tablets dissolve under the tongue and not to swallow them.

3. Rest and Activity Management

   • Encourage rest during any episodes of chest pain to reduce cardiac workload.

4. Communication and Reporting

   • Notify the MD if the use of PRN (as needed) NTG becomes frequent.
   • Document and report any episodes of chest pain and the patient’s response to NTG to the healthcare provider.

5. Patient Education

   • Educate the patient on recognizing early signs of angina and the importance of reporting chest pain immediately.
   • Teach the patient how to use NTG tablets correctly, emphasizing the importance of letting them dissolve under the tongue.

Rationale

1. Monitoring and Assessment

   • Regular monitoring and thorough assessment during chest pain episodes ensure timely detection and management of angina, reducing the risk of complications.

2. Medication Management

   • Proper administration and monitoring of NTG help relieve chest pain and prevent adverse effects, ensuring the patient's safety.

3. Rest and Activity Management

   • Encouraging rest during chest pain episodes helps reduce the heart's workload, promoting faster relief of symptoms.

4. Communication and Reporting

   • Prompt reporting of frequent NTG use and unrelieved chest pain allows for timely medical intervention, preventing severe complications.

5. Patient Education

   • Educating the patient on recognizing and managing angina empowers them to take an active role in their care and ensures proper use of medications.

Actions

1. Monitoring and Assessment

   • Check for chest pain every shift, documenting the presence or absence of pain.
   • Perform a comprehensive cardiac assessment if chest pain occurs, recording BP, AP, radial pulse, oxygen saturation, BLBS, respiration rate, and pain location.

2. Medication Management

   • Administer NTG as prescribed, monitoring for effectiveness and any side effects.
   • Measure BP between NTG doses to ensure safe administration. If BP is < 90/50, hold the next dose and inform the MD.
   • Report unrelieved chest pain after three NTG doses to the MD immediately.
   • Instruct the patient on the correct use of NTG, ensuring they understand to let the tablet dissolve under the tongue.

3. Rest and Activity Management

   • Encourage the patient to rest during episodes of chest pain to alleviate symptoms more quickly.

4. Communication and Reporting

   • Notify the MD if PRN NTG use increases, indicating possible worsening of angina.
   • Document each chest pain episode and the patient’s response to NTG, communicating these details to the healthcare team.

5. Patient Education

   • Teach the patient to recognize the signs of angina and the importance of reporting chest pain immediately.
   • Demonstrate the correct method for taking NTG tablets and ensure the patient understands the instructions.