MindMap Gallery Stable angina pectoris (nursing)
Regarding the stable angina pectoris (nursing) mind map, it summarizes the concepts, clinical manifestations, laboratory tests, diagnostic points, treatment principles, treatment points, commonly used nursing diagnosis/problem measures and basis, and health guidance.
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Dive into the world of the Chinese animated film Nezha 2: The Devil's Birth! This knowledge map, created with EdrawMind, provides a detailed analysis of main characters, symbolic elements, and their cultural significance, offering deep insights into the film's storytelling and design.
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stable angina
concept
Exertional angina. Coronary artery stenosis➕increased myocardial load
clinical manifestations
episodic chest pain
Location: behind the body of the sternum, affecting the precordium, with unclear boundaries
Radiation: left shoulder, inner side of left arm to ring finger and little finger. Neck, pharynx or mandible
Properties: oppression, stuffiness, tightness, burning sensation, dying sensation
Triggers: labor, emotional excitement
Duration: 3-5 minutes
Relief method: stop activity, take nitroglycerin sublingually
Signs: increased heart rate, increased blood pressure, sometimes the fourth or third heart sound gallop appears on apical auscultation, and there may be temporary apical systolic murmur
laboratory tests
Electrocardiogram
ST segment depression, T wave flat or inverted
Coronary multi-slice spiral CT angiography
radionuclide inspection
Invasive tests
Coronary angiography is currently the gold standard for clinical diagnosis of coronary heart disease.
Echocardiography
Diagnostic points
Canadian Cardiovascular Society CCS classification
Level I: Ordinary daily activities do not cause angina pectoris
Level II: daily physical activities are slightly limited, and emotional agitation is more obvious after meals
Level III: Daily physical activity is slightly limited and can be caused by walking 1km on level ground or going up a floor.
Level IV: Attack can occur with slight activity or even rest.
Treatment principles
Improve coronary blood supply and reduce myocardial oxygen consumption
Aggressive treatment of atherosclerosis
Avoid triggers and risk factors
Prevent myocardial infarction and sudden death
Treatment points
Treatment during an attack
rest
drug treatment
Nitroglycerin: 0.5 mg taken sublingually, effective in 1-2 minutes and disappears in 30 minutes. Can be reused every 5 minutes, no more than 3 times in a row
Adverse reactions: headache, flushing of face, hypotension, prone to orthostatic hypotension after first use
Isosorbide dinitrate: 5-10 mg sublingually, effective in 2-5 minutes, and the effect lasts 2-3 hours
Treatment during remission (Bed rest is generally not required)
drug treatment
Drugs to improve myocardial ischemia and relieve symptoms
beta receptor antagonists
Slow down the heart rate, reduce myocardial contractility, and reduce myocardial oxygen consumption
metoprolol, bisoprolol
Nitrate preparations
Endothelium-independent vasodilators
calcium channel blockers
Inhibit myocardial contraction, dilate coronary arteries, relieve coronary artery spasm, and improve blood supply to subendocardial myocardium
verapamil, nifedipine, diltiazem
Others: trimetazidine
Drugs to prevent myocardial infarction and improve prognosis
Cyclooxygenase (COX) inhibitors
Aspirin, indobufen
P₂Y₁₂ receptor antagonists
Clopidogrel, Ticagrelor
Lipid regulating drugs
Statins
ACEI or ARB
ACEI: Captopril, Enalapril
If an irritating dry cough occurs, use an ARB
ARB: Losartan, Valsartan
coronary revascularization therapy
Percutaneous Coronary Intervention (PCI)
Coronary Artery Bypass Grafting (CABG)
Enhanced external counterpulsation (EECP)
Common nursing diagnosis/problem measures and basis
Pain: chest pain (Related to myocardial ischemia and hypoxia)
Rest and activities
psychological care
pain observation
Medication care
sublingual nitroglycerin
If attacks occur frequently, intravenous infusion of nitroglycerin can be given as directed by the doctor.
statins
Timely detection of liver function damage and myopathy caused by
PCI care
Reduce or avoid disease triggers
Decreased activity tolerance (Related to the imbalance between myocardial oxygen supply and demand)
Assess the level of activity restrictions
Develop an activity plan. Patients in remission generally do not need bed rest.
Observe and deal with adverse reactions during activities
health guidance
Disease knowledge guidance
Reasonable meals
Quit smoking and limit alcohol
Moderate exercise
psychological balance
avoid triggers
Disease monitoring guidance
Medication guidance