Nursing Management and Acute Coronary Syndrome

Nursing Management

• Nursing management exists before, during, and after the progression of a disease process.
• Nursing diagnoses, with their respective goals, expected outcomes, interventions, and evaluations are essential aspects of nursing management.
• Nursing interventions can be categorized as:
  • Promotion/Prevention
  • Rehabilitative
  • Curative

Acute Coronary Syndrome

• It is the number one leading cause of death
• Chest discomfort (pain) spreading to both or one arm, shoulder pain spreading into the back, stomach pain, and neck pain radiating to the jaw.
• Unexplained pressure or tightness in the center of the chest lasting several minutes, lightheadedness, dizziness, nausea, and sweating.
• Unexpected sudden shortness of breath.
• Levin's signs can indicate chest pain: clenching fist over chest, open hand over chest, and pointing to lungs.

Pathophysiology

• The process of a disorder focusing on the underlying mechanism causing an abnormal state.
• The body's physiologic state is affected, leading to a medical diagnosis.
• Etiology of pathophysiology can be internal and external.
  • External: Pathogens
  • Internal: Immune system
    • Immunodeficiency
    • Hypersensitivity
• Etiology can be categorized as modifiable and non-modifiable.
  • Non-Modifiable:
    • Age
    • Genetics
    • Idiopathic
  • Modifiable:
    • Stress
    • Environment
    • Lifestyle
    • Untreated preventable disease

Pathogenesis

• The onset and development of a disease due to certain etiologies.
• Hypertension: Increased blood pressure can damage the intima (inner layer of the artery), leading to leakage and clot formation.
• Cholesterol: High cholesterol levels contribute to plaque buildup in arteries, narrowing and hardening them (atherosclerosis and sclerosis)

Clinical Manifestations of ACS

• Assessing ABCs and Level of Consciousness (LOC) is crucial.
• Immediate vital signs are essential for monitoring the patient's condition.
• Oxygen administration for ischemic stroke.
• Cardiac markers:
  • Myoglobin: Detectible after one hour
  • Troponin: Detectible after three hours
  • CK-Mb: Detectable after four to six hours
  • aSt: Detectable after eight hours
  • LDH: Detectable after 24 hours
• ECG is the first diagnostic test typically performed in a patient with suspected ACS.

Nursing Management for ACS

• Triage management involves assessing ABCs and LOC, recording immediate vital signs, and administering oxygen if SpO2 levels indicate ischemia.
• Titration of medications, with a maximum dose of 50 ml/hr, is performed to achieve optimal therapeutic effects.
• Drug dosages are adjusted based on BP and SpO2 levels.

BE FAST

• Balance: Sudden loss of balance, dizziness, or confusion.
• Eyes: Sudden vision changes or blurry vision.
• Face: Facial drooping (one side of the face), difficulty smiling.
• Arms: Weakness or numbness in one arm or leg.
• Speech: Slurred or difficulty speaking.
• Time: Time is crucial; seek immediate medical attention if any of these symptoms are observed.

This quiz covers important aspects of nursing management related to acute coronary syndrome, including nursing diagnoses, interventions, and the pathophysiology of the condition. It emphasizes the significance of understanding symptoms and nursing strategies for effective patient care. Test your knowledge on these critical nursing concepts and improve your assessment skills.