Pathophysiology Statement- Audria G.
Baker
Nature of the Problem: Coronary Artery Disease
Effects on Body
Organ/Functioning
Coronary Artery Disease- CAD
is the leading cause of death in
the US. The coronary arteries
supply the myocardial muscle
with oxygen and the nutrients
necessary for optimal function. In
CAD, the arteries are narrowed
or obstructed, potentially
resulting in cardiac muscle
death. Atherosclerotic lesions,
arterial spasm, platelet
aggregation, and thrombus
formation all may cause
obstruction.
Signs and Symptoms Treatment Nursing Interventions Complications
Chest pain, substernal Healthy diet Monitor blood pressure, apical heart
Heart attack
rate, and respirations every 5 minutes
pressure and burning, during an anginal attack.
Exercise
and pain that radiates Heart Failure (HF)
Maintain continuous ECG monitoring or
to the jaw, shoulder or Smoking cessation obtain a 12-lead ECG, as directed,
arm. Weakness, monitor for arrhythmias and ST Angina pectoris
elevation.
diaphoresis, N/V, SOB, Meds-
Arrhythmia
and acute anxiety. Place patient in comfortable position and
Bradycardia may be
anticoagulants , administer oxygen, if prescribed, to
aspirin and other enhance myocardial oxygen supply. Mitral valve prolapse
present esp in right antiplatelet
coronary artery infarct medicines, ACE Identify specific activities patient may
engage in that are below the level at
(RCA.) Tachycardia inhibitors, beta which anginal pain occurs.
may also be present. blockers, calcium
channel blockers, Reinforce the importance of notifying
nursing staff whenever angina pain is
nitroglycerin,
experienced.
glycoprotein, statins,
and fish oil and other Encourage supine position for dizziness
supplements high in caused by antianginals.
omega-3 fatty acids.
Be alert to adverse reaction related to
abrupt discontinuation of beta-adrenergic
Angioplasty and blocker and calcium channel blocker
CABG. therapy. These drug must be tapered to
prevent a “rebound phenomenon”;
tachycardia, increase in chest pain, and
hypertension.
Explain to the patient the importance of
anxiety Teach the patient relaxation
techniques.
Review specific factors that affect CAD
development and progression; highlight
those risk factors that can be modified
 and controlled to reduce the risk.

Patient Specific Patient Specific Patient Specific Patient Specific Patient Specific

Monitor blood pressure, apical heart

SOB, Bradycardia Pt has had a past MI.
rate, and respirations.

Pt has CAD and ischemic Healthy diet Place patient in comfortable position to Pt currently has HF,
cardiomyopathy. help with SOB.
angina and Arrhythmia’s.
Exercise
Administer Aspirin.
Smoking cessation
Reinforce the importance of notifying
Meds- nursing staff whenever angina pain is
experienced.

Aspirin Encourage supine position for dizziness

caused by antianginals.

Be alert to adverse reaction related to

abrupt discontinuation of beta-adrenergic
blocker and calcium channel blocker
therapy. These drug must be tapered to
prevent a “rebound phenomenon”;
tachycardia, increase in chest pain, and
hypertension.

Explain to the patient the importance of

anxiety Teach the patient relaxation
techniques.

Review specific factors that affect CAD

development and progression; highlight
those risk factors that can be modified
and controlled to reduce the risk.

References:

Kozier and Herb- Fundamentals of Nursing, Mosby’s Medical Surgical Nursing, All-in-One Care Planning Resource by Swearingen.