4 Angina Pectoris (Coronary Artery Disease) Nursing Care Plans

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Coronary artery disease (CAD) is a condition in which plaque builds up inside the coronary arteries. Coronary arteries are arteries that supply the 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 the coronary arteries are narrowed or blocked, oxygen-rich blood can’t reach the heart muscle. This can cause angina or a heart attack. Without quick treatment, a heart attack can lead to serious problems and even death.

The classic symptom of coronary artery disease (CAD) is angina—pain caused by loss of oxygen and nutrients to the myo­cardial tissue because of inadequate coronary blood flow. In most but not all patients presenting with angina, CAD symptoms are caused by significant atherosclerosis. Unstable angina is sometimes grouped with MI under the diagnosis of acute coronary syndrome.

Angina has three major forms:

  1. stable: precipitated by effort, of short duration, and easily relieved,
  2. unstable: longer lasting, more severe, may not be relieved by rest or nitroglycerin; may also be new onset of pain with exertion or recent acceleration in severity of pain.
  3. variant: chest pain at rest with ECG changes due to coronary artery spasm.

Nursing Care Plans

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 arteries.

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Here are four (4) angina pectoris (coronary artery disease) nursing diagnosis and nursing care plans (NCP):

  1. Acute Pain
  2. Deficient Knowledge
  3. Anxiety
  4. Risk for Decreased Cardiac Output
  5. Other possible nursing care plans
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Anxiety

Nursing Diagnosis

  • Anxiety

May be related to

  • Situational crises
  • Threat to self-concept (altered image/abilities)
  • Underlying pathophysiological response
  • Threat to or change in health status (disease course that can lead to further compromise, debility, even death)
  • Negative self-talk

Possibly evidenced by

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  • Expressed concern regarding changes in life events
  • Increased tension/helplessness
  • Apprehension, uncertainty, restlessness
  • Association of diagnosis with loss of healthy body image, loss of place/influence
  • View of self as noncontributing member of family/society
  • Fear of death as an imminent reality

Desired Outcomes

  • Verbalize awareness of feelings of anxiety and healthy ways to deal with them.
  • Report anxiety is reduced to a manageable level.
  • Express concerns about effect of disease on lifestyle, position within family and society.
  • Demonstrate effective coping strategies/problem-solving skills.
Nursing InterventionsRationale
Explain purpose of tests and procedures: stress testing.Reduces anxiety attributable to fear of unknown diagnosis and prognosis.
Promote expression of feelings and fears. Let patient/SO know these are normal reactions.Unexpressed feelings may create internal turmoil and affect self-image. Verbalization of concerns reduces tension, verifies level of coping, and facilitates dealing with feelings. Presence of negative self-talk can increase level of anxiety and may contribute to exacerbation of angina attacks.
Encourage family and friends to treat patient as before.Reassures patient that role in the family and business has not been altered.
Tell patient the medical regimen has been designed to limit future attacks and increase cardiac stability.Encourages patient to test symptom control, to increase confidence in medical program, and to integrate abilities into perceptions of self.
Administer sedatives, tranquilizers, as indicated.May be desired to help patient relax until physically able to reestablish adequate coping strategies.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for cardiovascular system disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
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