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
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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.
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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.
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Rest and Activity Management
- Encourage rest during any episodes of chest pain to reduce cardiac workload.
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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.
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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
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Monitoring and Assessment
- Regular monitoring and thorough assessment during chest pain episodes ensure timely detection and management of angina, reducing the risk of complications.
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Medication Management
- Proper administration and monitoring of NTG help relieve chest pain and prevent adverse effects, ensuring the patient's safety.
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Rest and Activity Management
- Encouraging rest during chest pain episodes helps reduce the heart's workload, promoting faster relief of symptoms.
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Communication and Reporting
- Prompt reporting of frequent NTG use and unrelieved chest pain allows for timely medical intervention, preventing severe complications.
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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
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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.
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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.
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Rest and Activity Management
- Encourage the patient to rest during episodes of chest pain to alleviate symptoms more quickly.
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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.
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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.
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