Acute coronary syndrome (ACS) refers to a group of conditions due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. The most common symptom is chest pain, often radiating to the left arm or angle of the jaw, pressure-like in character, and associated with nausea and sweating. Acute coronary syndrome usually occurs as a result of one of three problems: ST elevation myocardial infarction (30%), non ST elevation myocardial infarction (25%), or unstable angina (38%).
Nursing Care Plan for Acute Coronary Syndrome
Nursing Diagnosis : Acute Pain related to tissue ischemia secondary to coronary artery occlusion.
Goal: pain experienced by the patient can be reduced.
Expected outcomes:
- The client states chest pain is gone / controlled.
- The client can demonstrate relaxation techniques.
- The client may indicate reduced tension, relaxed and easy to move.
1. Provide a comfortable environment, calm, and give slow activity.
R /: Lowering external stimuli in which anxiety and heart strain and limited coping skills and decisions on the current situation.
2. Assist the client in relaxation techniques such deep breaths / slowly, distraction, visuallisasi, guidance imagination.
R /: Helps in reducing the pain response.
3. Provide supplemental oxygen by nasal cannula or mask as indicated.
R /: Increase the amount of oxygen available for the use of the myocardium and also reduces discomfort with respect to tissue ischemia.
4. Give the drug as indicated.
R /: To control pain and increase peace of patients to the healing process runs smoothly.
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