Nursing Care Plan for Anxiety related to Angina Pectoris

Manifestations of Myocardial Ischemia, usually due to a narrowing or blockage of the coronary arteries are the most frequent angina pectoris, acute myocardial infarction and sudden death, but sometimes it can also arise as heart failure or arrhythmias. William Heberden in 1768 has reported the clinical syndrome of angina pectoris and discussed this with the perfect introduction and management.

Angina pectoris is pain or discomfort in the area of ​​the heart or substernal (chest discomfort), primarily due to physical activity or stress, will subside when the rest or sublingual nitrate meal. It can also spread to the neck and arm till left.

Clinical manifestations include:

• Substernal or retrosternal chest pain radiating to the neck, throat area inter scapula or left arm.
• Quality of pain like a heavy pressure, squeezing, hot, sometimes just a bad feeling in the chest (chest discomfort).
• Duration of pain lasts 1 to 5 minutes, no more daari 30 minutes.
• Pain is lost (reduced) when the rest or nitroglycerin.
• Accompanying symptoms : shortness of breath, feeling tired, sometimes appearing cold sweat, palpitations, dizzines.

Nursing Diagnosis : Anxiety
related to :

• Crisis situation.
• The threat to the self-concept (image disturbance / capability).
• Pathophysiological responses.
• Threats to or change in health status (disease) which may lead to further changes, disability, and even death).
• Talk negatively about self.

Possibility evidenced by :

• Expressing problem with respect to the change of life.
• Increased helplessness.
• Fear, anxiety.
• Diagnosis relations with the loss of a healthy self-image, loss of influence.
• Self-image as a person who does not affect the family / community.
• Fear of death as a reality.

Nursing Interventions :

Independent

1. Explain the purpose of tests and procedures, examples of the stress test.
R/ : Lowers anxiety and fear of the diagnosis and prognosis.

2. Increase the expression of feelings and fear, eg refuse, depressed and angry. Let the patient / person nearest to know this as a normal reaction. Note the example problem statement "heart attack is inevitable".

R/ : Feelings are not expressed can lead to internal chaos and self-image effects. Statement of the problem to reduce tension, to clarify the level of coping, and facilitate understanding of feelings. The existence of negative self- talk about increasing anxiety and attacks of angina.


3. Encourage family and friends to consider patients as before.
Tell patient medical programs that have been made to reduce / limit the attack will come and increase the stability of the heart.
R/ : Encourage the patient to control the symptoms of the test, to increase confidence in the medical program and integrate capabilities in perception of self.

Collaboration

4. Give sedatives , tranquilizers as indicated.
R/ : It may be necessary to help the patient relax until physically able to make adequate coping strategies.