Nursing care plan for acute coronary syndrome

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Introduction

Acute coronary syndrome (ACS) is an umbrella term used to describe a range of medical conditions caused by reduced blood flow to the heart. It includes, unstable angina (UA), non-ST segment elevation myocardial infarction (NSTEMI) & ST segment elevation myocardial infarction (STEMI). It is also known as a silent killer due to its high mortality and tendency to cause sudden death. To ensure proper care and treatment of ACS, professionals need to be aware of the different components of nursing care plan that has to be developed for ACS.

Assessment

Symptomatology: Symptoms including chest pain, pressure and discomfort, palpitations, dyspnea, diaphoresis, nausea, dizziness, and lightheadedness should be detected.

Diagnostic tests: Appropriate diagnostic tests such as ECG, Troponin, CBC and BNP should be taken.

Medical history: A complete medical history including past cardiac history, risk factors, current medications, family history, and lifestyle should be documented.

Physical assessment: Physical examination should include vital signs and signs of cardiac compromise.

Nursing Diagnosis

• Ineffective tissue perfusion related to reduced myocardial oxygen supply secondary to ACS.
• Ineffective health maintenance related to inadequate knowledge about self-care and lifestyle modifications.
• Risk for Infection related to characterized presence of acute respiratory failure.
• Ineffective coping related to fear of dying or having a recurrent of cardiac event.

Outcomes

• The patient will be able to maintain adequate oxygenation and tissue perfusion.
• The patient will be able to explain the treatment plan.
• The patient will demonstrate effective coping strategies for stress management.
• The patient will follow doctor's advice in terms of medication and lifestyle modification.
• The patient will have increased understanding of risk factors related to ACS.

Interventions

• Evaluate and monitor vital signs, chest pain, ECGs, laboratory findings and other diagnostic modalities on regular basis.
• Educate patient about lifestyle modifications, diet, exercise and importance of compliance with therapy.
• Provide appropriate patient education in regard to risk factors, medications, and self-care measures.
• Provide emotional support and reassurance to the patient and family.
• Monitor neurosensory status
• Encourage patient to grieve loss when needed.

Rationales

Monitoring vital signs is important to identify any changes in patient’s condition and initiate timely intervention. Health education helps in reducing anxiety and provides necessary information to the patient and their families. Emotional support and counseling provides an opportunity to address concerns, stress, and psychological implications of the diagnosis. It also improves patient satisfaction.

Evaluation

Patient’s symptoms are managed within normal limit.
Patient shows understanding of self-care practices.
Patient recovers emotionally.

Conclusion

ACS can lead to serious complications and even mortality if not managed properly in time. Several interventions are available to diagnose, prevent, and treat ACS. However, the most important part of managing ACS is developing an effective nursing care plan using a holistic approach to ensure optimal results.

FAQs

• What is Acute Coronary Syndrome (ACS)?
  ACS is an umbrella term used to describe a range of medical conditions caused by reduced blood flow to the heart. It includes unstable angina, non-ST segment elevation myocardial infarction, and ST segment elevation myocardial infarction.
• What are the symptoms of ACS?
  Symptoms of ACS include chest pain, pressure and discomfort, palpitations, dyspnea, diaphoresis, nausea, dizziness, and lightheadedness.
• What are some of the interventions to manage ACS?
  Interventions to manage ACS include monitoring vital signs, laboratory tests, and other diagnostic modalities; providing emotional support and reassurance to patient and family; educating patient about lifestyle modifications, diet and exercise; and providing emotional support and counseling.
• What tests are done for the diagnosis of ACS?
  Tests for the diagnosis of ACS include ECG, Troponin, CBC, and BNP.
• What are the outcomes of an ACS nursing care plan?
  Outcomes of an ACS nursing care plan include maintaining adequate oxygenation and tissue perfusion, ability to explain the treatment plan, demonstration of effective coping strategies, follow doctor's advice, and increased understanding of risk factors related to ACS.