1. Prof. LozadaDAPHANE I. TORRES MARIELLA BOBONIS QUILES JAIMEADALBERTO TOLEDO ALEXIS VELEZ TORRES HAROLD GOMEZ RIVERA

2. CORONARY ARTERY DISEASEANGIOGRAPHY (PROCEDURE) 3. Coronary heart disease (CHD) is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle. When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years. CHD is the most common type of heart disease. In the United States, CHD is the #1 cause of death for both men and women. Lifestyle changes, medicines, and medical procedures can help prevent or treat CHD. These treatments may reduce the risk of related health problems. 4. Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins and the heart chambers. This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy. 5. When a patient comes in the hospital with CAD they will commonly display the following problems. Decreased Cardiac Output Ineffective Tissue Perfusion Acute Pain Activity Intolerance FatigueAs future nursing professionals we will need to make a Nursing care plan for each health problem. For now we are going to choose one. 6. Depending of the severity of the CAD acute pain is the most common symptom that is seen in the hospital. 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. 7. AssessmentObjectivesMay manifest: restlessnessShort Term: After 3 hours 1. of nursing informative, the pt. Will verbalize 2. understanding of pts condition and health 3. teachings given to provide comfort and relieve of pain. 4.pain scale of 9/10 chest pain irritability (+) guarded behavior (+) facial grimaces crying v/s change diaphoresis sleep disturbance increase rr and pulseLong term After 2 days of nursing informative, the pt. Will demonstrate behavior of being relieved from pain and will be free from the complications of the condition.Nursing interventions5.6.7.Assess pt.s condition.Rationale 1.Monitor and record 2. v/s. Assess pains location and intensity/severity Provide comfort measures like stretching of linens and assisting in position.To have baseline data and this are usually altered in the condition.3.To have baseline data for planning and interventions.4.To provide nonpharmacological Pain management.Provide diversion 5. activities like having conversation 6. w/ the pt. 7. Stress to pt the importance of providing adequate rest period to the pt. Administer meds as ordered.To have baseline data.To divert pt.s attention. To prevent fatigue. To reduce pain.Expected outcome 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. 8. 1. 2. 3. 4. 5. 6. 7. 8.We will post a question on the screen. Anyone who knows the answer will raise their hand. The professor will select the student at her own discretion. The student will have 30 seconds to answer only ONCE! If the student answers wrong the professor will keep selecting students until question is answered. Once question is answered the student will receive a prize and the next question will proceed. The student can ask for help from fellow classmates. The professor can ONLY give hints that will help STEER the student in the right direction.LETS BEGIN! 9. Coronary heart disease (CHD) is a disease in which a waxy substance called builds up inside the coronary arteries. a) b)c) d)Plaque Arteries Plates Blood 10. What is an example of a non-modifiable risk factor for CAD? Smoking b) High blood pressure c) Age d) Obesity a) 11. What is done to the patient before he or she goes through an Angiography procedure? I.V. line will be started b) The patient will be placed on a heart monitor c) The patient will be given an oral or I.V. sedative d) All of the above a) 12. What is angina? a) b) c) d)Narrowing of the arteries Reduced blood flow Chest pain High blood pressure 13. In the Nursing interventions of the Nursing care plan for Acute pain; what was the rational for Assess pains location and intensity/severity? To have baseline data and this are usually altered in the condition. b) To have baseline data for planning and interventions. c) To have baseline data. d) To provide non-pharmacological Pain management. a) 14. Depending of the severity of the CAD is the most common symptom that is seen in the hospital. a) b)c) d)Acute pain Fatigue Emesis Activity tolerance