About

Contact
Archive
Disclaimer
Privacy Policy


NEWS
NOTES
EXAM QUESTIONS
NURSING CARE PLANS
MORE
Home Nursing Care Plans
5 Coronary Artery Disease Nursing Care
Plans
Nursing Care Plans
2012/02/04
10
49
1
7
0
22


79

Contents [show]
Definition & Pathophysiology
Coronary Artery Disease (CAD) is a condition in which plaque builds up inside the coronary
arteries. Coronary arteries are arteries that supply your heart muscle with oxygen-rich blood. Plaque
is made up of fat, cholesterol, calcium, and other substance found in the blood. Plaque narrows the
arteries and reduces blood flow to your heart muscle. It also makes it more likely that blood clots will
form in your arteries. Blood clots can partially or completely block blood flow. When your coronary
arteries are narrowed or blocked, oxygen-rich blood cant reach your heart muscle. This can cause
angina or a heart attack. Without quick treatment, a heart attack can lead to serious problems and
even death.
CAD is the most common type of heart disease. Lifestyle changes, medicines, and/or medical
procedures can effectively prevent or treat CAD in most people. Other names for Coronary Artery
Disease are Atherosclerosis, Coronary heart disease, Hardening of the arteries, Heart disease,
Ischemic heart disease, and Narrowing of the arteries.
Nursing Care Plans
Here are 5 Coronary Artery Disease Nursing Care Plans
Decreased Cardiac Output
NDx: Decreased cardiac output r/t increased vascular resistance
CAD causes narrowing of blood vessels. This condition leads to intense pressure exerted on the
walls of the blood vessels. The bodys compensatory mechanism is to increase the workload of the
heart and thus the patient has decreased cardiac output.
Assessment Planning Nursing
interventions
Rationale Expected outcome
S=
O=The patient
may manifest:
restlessness
increased bp
cold clammy
skin
decreased
peripheral
pulses
Short term:
After 2-3 hours of
nursing
interventions, the
patient will
verbalize
understanding of
disease process.
Long term:
After two days of
nursing
interventions the
patient will
participate in
activities to
decrease in the
hearts workload
1. assess patients
condition
2. monitor and
record vital
signs
3. encourage
patient to
verbalize
concerns
4. encourage
patient to
change
position every
two hours
5. encourage
patient to do
relaxation
techniques
6. encourage
patient to
engage in
diversional
activities such
as chatting
with family
and friends.
1. to determine
possible
problems
2. for baseline
data
3. to make client
express his
feelings
4. to improve
venous return
5. to reduce
stress
6. to divert
attention and
help patient
lessen
experienced
pain and
anxiety
7. to prevent
further
complications
of the disease
Short term:
The patient shall
have verbalized
understanding of
disease process.
Long term:
The patient shall
have participated
in activities to
decrease in the
hearts workload
7. reinforced low
salt and low fat
diet
Ineffective Tissue Perfusion
Ineffective tissue perfusion r/t decreased cardiac output
The oxygen content of arterial blood is almost all bound to hgb. In anemia, the oxygen content will
therefore fall in proportion to the reduction in hgb concentration, even though the po2 is normal. The
normal compensatory to restore oxygen delivery is an increase in cardiac output.
Assessment Objectives Nursing
interventions
Rationale Expected outcome
S o
O the patient
manifested the
following:
shortness of
breath
fatigue
The pt. May
manifest:
pallor
cool
temperature
decrease pulse
decrease urine
output
Short term:
After 3 hours of ni,
the pt. Will be able
to demonstrate
behaviors on how
to have effective
airways.
Long term:
After 1- 2 days of
ni, the patient will
free from shortness
of breath.
1. assess pt.s
condition.
2. monitor and
record v/s.
3. note color and
temperature of
the skin.
4. monitor
peripheral
pulse.
5. provide a
warmth
environment.
6. encourage
active rom.
7. monitor urine
output.
1. to have
baseline data.
2. to have
baseline data
and this are
usually altered
in the
condition.
3. cool, pale skin
is indicative of
decrease
peripheral
tissue
perfusion.
4. decrease pulse
is indicative of
decreased
tissue
perfusion from
vasoconstrictio
n of the
Short term:
The pt. Shall have
demonstrated
behaviors on how
to have effective
airways.
Long term:
The patient shall
be free from
shortness of
breath.
vessels.
5. a warm
environment
promotes
vasodilation
which
decreases
preload and
promotes
tissue
perfusion.
6. rom helps
decreases
venous pooling
and promotes
tissue
perfusion.
7. decreased
tissue
perfusion to
the kidneys
may result in
oliguria.
Acute Pain
Coronary artery disease (CAD) is caused by a narrowing of the arteries that supply the heart muscle
with blood. When the arteries narrow, blood flow is reduced. The reduced blood flow causes the
heart muscle to receive less oxygen than it needs to function properly. When ischemia occurs
patients typically develop angina or chest pain originating from the heart. It has been described as
chest pain or discomfort that has a squeezing or pressure-like quality, usually felt behind the
breastbone (sternum), but sometimes felt in the shoulders, arms, neck, jaws, or back.
Assessment Objectives Nursing
interventions
Rationale Expected outcome
S o
O the pt. May
manifest:
restlessness
pain scale of
9/10
chest pain
irritability
(+) guarded
behavior
(+) facial
grimaces
crying
v/s change
diaphoresis
sleep
disturbance
increase rr and
pulse
Short Term:After 3
hours of ni, the pt.
Will verbalize
understanding of
pts condition and
health teachings
given to provide
comfort and
relieve of pain.
Long term
After 2 days of ni,
the pt. Will
demonstrate
behavior of being
relieved from pain
and will be free
from the
complications of
the condition.
1. assess pt.s
condition.
2. monitor and
record v/s.
3. assess pains
location and
intensity/severi
ty arising with.
4. provide
comfort
measures like
stretching of
linens and
assisting in
position.
5. provide
diversional
activities like
having
conversation
w/ the pt.
6. stress to pt the
importance of
providing
adequate rest
period to the
pt.
7. administer
meds as
ordered.
1. to have
baseline data.
2. to have
baseline data
and this are
usually altered
in the
condition.
3. to have
baseline data
for planning
and
interventions.
4. to provide non-
pharmacologic
al Pain
management.
5. to divert pt.s
attention.
6. to prevent
fatigue.
7. to reduce pain.
The pt.s so will
verbalize
understanding of
pts condition and
health teachings
given to provide
comfort and
relieve of pain and
pt.

Will demonstrate
behavior of being
relieved from pain
and will be free
from the
complications of
the condition.
Activity Intolerance
Due to the disease condition, the patient lost the energy reserve and has increased need to adapt to
the pain of angina. Because of that she has limited movement. The inability to perform activities of
daily living is also due to fatigue.
Assessment Objectives Interventions Rationale Outcomes
Weakness Short term:
After 4 hours of
nursing
interventions and
health teachings,
the patient will
be able to use
identified
techniques to
enhance activity
intolerance.
Long term
After 2-4 days of
nursing
interventions, the
patient will be
able to participate
willingly in
necessary
activities.
1. monitor and
record vital
signs
2. teach method
to increase
activity level
3. plan care with
rest periods
between
activities
4. provide
positive
atmosphere
5. assist with
activities
6. promote
comfort
measures
7. encourage
participation
and diversion
of activities
1. for baseline data
2. to conserve
energy
3. to reduce fatigue
4. to minimize
frustrations
5. to protect from
injury
6. to reduce pain
7. to minimize pain
Short term:
The patient shall
have identified and
used techniques to
enhance activity
intolerance.
Long term:
The patient shall
have participated
willingly in
necessary
activities.
Fatigue
Fatigue is a overwhelming sense of exhaustion resulting to decreased capacity to perform activities
at the usual level. This is due to the patients poor physical condition brought about by the disease
condition.
Assessment Objectives Interventions Rationale Outcomes
S=
O=
the patient may
manifest:
verbalization of
overwhelming
lack of energy;
compromised
libido;
lethargy or
listless
drowsiness
disinterest in
surroundings
decreased
performance
weight gain
Short term:
After 2 hours of
nursing
interventions, the
patient will be
able to verbalize
understanding of
condition and
causative factors.
Long term:
After 3 days of
nursing
interventions, the
patient will be
able to perform
adls and
participate in
desired
activities/level of
activity.
1. monitor vital
signs
2. determine
ability to
participate in
activities/level
of mobility.
3. establish
realistic
activity goals
with client
4. plan care to
allow
individually
adequate rest
periods,
schedule
activities for
periods when
client has the
most energy
5. provide
environment
conducive
6. give
medication as
doctors ordered
1. to provide
baseline data
2. to enhances
commitment to
promoting
optimal
outcomes
3. to maximize
participation
4. to encourage
patients
cooperation
5. to
maintain/increa
se strength and
muscle tone
and to enhance
sense of well-
being.
6. to lessen
fatigue
Short term:
The patient shall
have verbalized
understanding of
condition and
causative factors.
Long term:
The patient shall
have performed
adls and
participate in
desired
activities/level of
activity.
TAGS
ACTIVITY INTOLERANCE
ACUTE PAIN
CARDIOVASCULAR PROBLEMS
DECREASED CARDIAC OUTPUT
FATIGUE
HEART DISEASE
INEFFECTIVE TISSUE PERFUSION
PREVIOUS ARTICLE
6 Drug Reference Sites You Must Bookmark!
NEXT ARTICLE
Defense Mechanisms List
SIMILAR ARTICLES

6 Peritonitis Nursing Care Plans
2014/02/27
0

4 Urolithiasis (Renal Calculi) Nursing Care Plans
2013/10/02
0

3 Pancreatitis Nursing Care Plans
2013/08/02
0

8 Laminectomy (Disc Surgery) Nursing Care Plans
2013/08/01
1
10 COMMENTS
1. Lisa2014/06/11 at 9:50 AM
I am a currently a nursing student and almost ready to give up! So overwhelming. I have used this
site before and yes It has helped. Thank you :-) is there anywhere I can find rational to
interventions for care plans?? Pls help
Reply
2. mildred Minayo2014/04/03 at 8:15 PM
you have really helped me in updating my care plan with nursing diagnosis.thanks alot
Reply
3. mildred Minayo2014/04/03 at 8:10 PM
lovely empowering nurses
Reply
4. Faye2014/03/12 at 11:42 PM
You guys are amazing! this your website is helping me through nursing school in so many
waysTHANK YOU
Reply
o Matt Vera2014/03/13 at 10:48 AM
Youre welcome Faye! Glad to help!
Reply
5. Raka2012/04/27 at 7:57 AM
Wow, I am so encouraged by this wsbtiee!I am 55 yrs old. On Sept. 9, 2011 I had a weird back/and
chest pain. After an angiogram I was diagnosed with SCAD, my RCA had a dissection in the smaller
vessel so couldnt be stinted.Upon getting ready for work one morning, I developed back/chest pain
that lasted 40 min. It radiated from my upper back to my upper sternum. Being diagnosed with
SCAD leaves me feeling alone as little is known about SCAD and most Drs have never heard of it.
My Cardiologist has me on 81 mg aspirin and 75 mg Plavix, and wants another angiogram in 6 mos.
He advised no lifting nor exercise for several months. Bummer! ( this has been hard and
depressing). I am an avid walker/hiker, dont smoke nor drink and my angiogram showed a healthy
heart, I dont have high BP, eat healthy (for the most part!) and am not overweight 54 110
pounds.This is so disappointing and all my friends say and youre so healthy! I feel like a walking
time bomb as no one knows what can prevent this. Therefore I am very interested in this study.I
have concerns over having another angio. Do yo think this is necessary? I would like to have a less
invasive test. My Dr. still wants to go ahead and sched. one for Feb.I want to mention that in 2010 I
had a routine vag. hysterectomy w/ A&P repair, of which I had 3 spontaneous hemorrhages from
each site in the 4th ,5th and 6th week post op. I saw many Doctors and ended up in Loma Linda
Med Ctr. in CA. This was extremely frightening and almost died of blood loss. The specialists told
me I was very rare, strange and unheard of. My vessels from each incision had to be cauterized
wondering if there is any relationship in regards to my vessel tenacity/turgor along with fluctuating
hormones. The Drs were so puzzled and still are. I am continually haunted, emotionally over this.
Now I am again told, with SCAD, that this is very rare ..I am looking forward to what will be learned
in this study, and hope I can be of some use!Thank youElaine
Reply
o Sarah2014/01/13 at 7:12 AM
Do you mean scad as in short chain acyl-coA dehydrogenase deficiency?
Reply
6. Deepa2011/11/12 at 5:06 PM
Thanks for the
awesome post. I liked it a lot. Great
work, keep it up.
Reply
o Nurseslabs2011/11/12 at 5:37 PM
Youre welcome!
Reply
7. Cristian2012/04/28 at 2:31 AM
I am 51 yrs old and Ive had two SCADs in the last year. One on the inferal larteal branch of the
circumflex coronary artery in October 2010 and one on the left anterior descending coronary artery
September 2011. Im in Oregon for those others here After the first one, they put me on a statin,
plavix and metoprolol. I also took CoQ10 and calcium and magnesium at the recommendation of a
naturopath. I stopped taking the statin after I talked to the naturopath, my pharmacist and a physical
therapist I know. I was also reading Dean Ornishs book on Reversing Heart Disease and they all
held similar opinions about statins for people without family history of high cholesterol. I started
eating more vegetables and fruit, less rice, bread and pasta and less refined sugar. I added dried
fruits and nuts to my diet and lost 15lbs. I felt good! I was so excited to be released from the Plavix in
July 2011 after the October 2010 heart attack. I was getting goose eggs everytime I bumped into
anything. In late August I walked the Portland to Coast Relay and in early September I had the
second dissection. There has been no cardiac follow up yet. I dont think they know what to say. And
when they told me in the hospital that it didnt matter what I did, I got depressed. Doctors should
never say things like that. The connection between body and mind is too strong. So, I made an
appointment with a therapist and I signed up for cardiac rehab, if thats all theyve got for me then Im
going for it. At least then I can feel like Im doing something. I know I cant control this, but I can do
the best I can at being healthy and engaged in life.
Reply
Leave a Reply




Post Comment

Notify me of follow-up comments by email.
Notify me of new posts by email.
Recent Posts

NCLEX Exam: Psychiatric Nursing 4 (20 Items)
2014/07/16
0
Don't let this 20-item quiz fool you. It may look short for 20 items but the questions are painstakingly
challenging. Don't forget to read the rationale at the end of the quiz.

NCLEX Exam: Fundamentals of Nursing 3 (30 Items)
2014/07/15

NCLEX Exam: Maternal and Child Health Nursing 2 (30 Items)
2014/07/14

NCLEX Exam: Growth and Development 2 (20 Items)
2014/07/11

1,000 Filipino Nurses Needed by Oman MOH
2014/07/09
LOAD MORE
More Care Plans

5 Pneumonia Nursing Care Plans
2012/01/12
Nursing Care Plan Format/Form Free Download
2011/09/24

5 Benign Prostatic Hyperplasia (BPH) Nursing Care Plans
2013/07/14

2 Alzheimers Disease Nursing Care Plans
2012/02/01

Metabolic Alkalosis Nursing Care Plan
2014/02/28
LOAD MORE
Recommended Books
Like us on Facebook

Nurseslabs is For All Your Nursing Needs!
Subscribe via Email
Enter your email address to subscribe to this blog and receive notifications of new posts by email.
Email Address

Subscribe

Recent Comments
prerana maharjan on 5 Chronic Renal Failure Nursing Care Plans
Guirlain on NCLEX Exam: Gastrointestinal Disorders 3 (50 Items)
Angelo Llaguna on Nursing Board Exam Questions
Angelo Llaguna on Nursing Board Exam Questions
Angelo Llaguna on Fundamentals of Nursing Exam 1 (50 Items)
Nurseslabs - Ut In Omnibus Glorificetur Dei

Related Searches


?
Nursing Careers
RN To BSN Degree
Nursing Students
American Nurses Association
Nurse Training
Medical-Surgical Nursing Certification
Webfuii