1. The client/caregiver can define “angina pectoris.”
   1. Chest pain is caused by insufficient oxygen to meet demands of the heart.
   2. A lack of oxygen occurs when insufficient blood flows through the coronary arteries.
   3. Stable angina usually has a precipitating cause, while unstable angina can occur at rest.
2. The client/caregiver can recognize signs and symptoms of angina pectoris.
   1. Chest pain (may range from very mild to very severe)
   2. Anxiety
   3. Indigestion
   4. Sweating
   5. Shortness of breath
3. The client/caregiver can list locations where chest pain can occur.
   1. Midanterior chest
   2. Neck and jaw
   3. Inner aspects of arms (left arm is more common)
   4. Upper abdomen
   5. Shoulders and between shoulder blades
4. The client/caregiver can list possible precipitating factors and appropriate measures to decrease risk.
   1. Factors: sudden physical exertionMeasures:
      • Exercise regularly.
      • Take regular rest periods, and avoid strenuous activities.
      • Have nitroglycerin available to take as directed if chest pain presents (use nitroglycerin/nitrates medication teaching guide).
   2. Factors: emotional stressMeasures:
      • Learn relaxation and stress management.
   3. Factors: consumption of a heavy mealMeasures:
      • Eat small, frequent meals.
      • Rest after meals.
   4. Factors: temperature extremesMeasures:
      • Dress warmly in cold weather.
      • Avoid sleeping in cold rooms.
      • Avoid becoming overheated.
      • Monitor reaction to a hot shower in the morning and sitting near the fireplace.
   5. Factors: nicotineMeasures:
      • Avoid smoking and other people’s smoke
   6. Factors: hypertensionMeasures:
      • Take medications as prescribed.
      • Monitor blood pressure closely.
      • Monitor cholesterol levels.
   7. Factors: obesityMeasures:
      • Achieve and maintain an ideal weight (use weight-reduction teaching guide).
      • Eat healthy meals low in saturated fat, cholesterol, and sodium (use cardiovascular-related nutrition teaching guide).
   8. Factors: constipation accompanied by excessive straining.Measures:
      • Eat a diet high in fiber (use the high-fiber diet teaching guide).
      • Exercise regularly.
      • Take stool softeners as needed. Discuss use with a physician.
5. The client/caregiver can list what to do if an angina attack occurs.
   1. Take nitroglycerin at the first sign of angina.
   2. Rest in a lying or sitting position.
   3. Maintain a quiet environment.
   4. If the client feels no relief 5 minutes after taking nitroglycerin, take nitroglycerin again. If another 5 minutes pass and the client feels no relief, take nitroglycerin a third time.
   5. If the client feels no relief 5 minutes after the third nitroglycerin, get medical attention.
6. The client/caregiver can list possible complications.
   1. Dysrhythmias of the heart
   2. Myocardial infarction
   3. Cardiac arrest leading to sudden death

Resources

American Heart Association
www.americanheart.org

National Institutes of Health
www.nih.gov

American Dietetic Association
www.eatright.org

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com