!

"# %&'" ()**&+&

(,--./. ,0 123!41/
.C. 8ox 4437 1003 MAnlLA, PlLllnLS 1LLLlAx: 733-6011 Lo 13 Loc. 4131


1"5&6 aLlenL M 7+&6 62 !&86 Male (9:9* !;";<=6 Marrled 3&*9+9)#6 8oman CaLhollc
(>9&? ()5@*"9#6 ChesL aln: SumaklL blgla ang puso ko" as verballzed by Lhe paLlenL.
A9"+#)=9=6 CASPu, PCvu, LvP, lschemla & ll-8
B";9&#;C= D9=;)EF6
! uleL: Low SalL Low laL uleL
! (+) for PyperLenslon
! WlLh hlsLory of back paln
BE9)E9;F
A9"+#)=9=
1<E=9#+ A9"+#)=9= G BE)H*&5I .;9)*)+FI !9+#= J
!F5@;)5=
K>F 9= 9; " @E9)E9;F ):&E ;>& #&8;

L





M




! AcuLe paln relaLed Lo myocardlal
lschemla secondary Lo arLerlal occluslon
as evldence by chesL paln.



! AcuLe paln relaLed Lo decreased
myocardlal blood flow as evldence by
chesL paln.


-1he flrsL prlorlLy, are Lhe Lhlngs LhaL affecL Lhe comforL of Lhe
paLlenL. And due Lo Lhe paln experlence by Lhe paLlenL, Lhls should be
Lhe flrsL prlorlLy of Lhe nurse Lo be LreaLed.



-AcLual problems should be prlorlLles flrsL so lL won'L lead Lo a worsL
problem.








N





O






P




Q


! uecreased cardlac ouLpuL relaLed Lo
pump fallure of Lhe lefL venLrlcle as
evldence by hyperLrophy and chesL
paln.


! lmpalred cardlac ouLpuL relaLed Lo
alLered blood flow and oxygenaLlon Lo
cardlac muscle as evldence by
hyperLenslon and chesL paln.



! lneffecLlve Llssue perfuslon relaLed Lo
alLered arLerlal blood flow as evldence
by lncrease ln blood pressure.


! AcLlvlLy lnLolerance relaLed Lo oxygen
supply/demand lmbalances as evldence
by hyperLenslon.



-ump lallure ls also relaLed Lo paln and LhaL also conLrlbuLes on
paLlenL's dlscomforL.




-AlLered blood flow causes vasoconsLrlcLlon LhaL may affecL Lhe
paLlenL's hearL LhaL mlghL Lrlgger hls chesL paln or hearL's pump
mlghL fall.




-1hough lL ls also a lack of comforL accordlng Lo prlorlLlzaLlon, among
all of Lhem Lhe hyslologlc need lasLly follows.



-ually acLlvlLles of Lhe paLlenL should be monlLor Lo help Lhe paLlenL
cope on hls/her changes ln body funcLlon.


-revenLlon ls second Lo acLual dlagnosls.

!"# %&'" ()**&+&
(,--./. ,0 123!41/
.C. 8ox 4437 1003 MAnlLA, PlLllnLS 1LLLlAx: 733-6011 Lo 13 Loc. 4131



7!!.!!R.1S

A47/1,!4!

37S4,17-.

B-71141/

123!41/ 41S.3T.1S4,1

37S4,17-.

.T7-27S4,1

*Su8!LC1lvL:
SumaklL blgla ang
puso ko." As
verballzed by Lhe
paLlenL.


*C8!LC1lvL:

! PyperLenslon
! ChesL paln
! vlLal slgns
Laken:

8: 180/90
1LM: 37.2C
88: 22 bpm
8: 64 bpm

lmpalred cardlac
ouLpuL relaLed Lo
alLered blood flow
and oxygenaLlon
Lo cardlac muscle
as evldence by
hyperLenslon and
chesL paln.

Anglna ls caused
by myocardlal
lschemla whlch
occurs whenever
myocardlal
oxygen demand
exceeds oxygen
supply.
Any condlLlon ln
whlch Lhere's a
decrease ln
oxygen dellvery by
Lhe coronary
arLerles, an
lncrease ln cardlac
workload, or an
lncrease ln Lhe
myocardlum's
oxygen
requlremenLs.






AfLer 2 weeks of
nurslng
lnLervenLlon Lhe
paLlenL wlll:

!"#$% '($)*

! 8eporL
paln ls
relleved.


! lollow
prescrlbed
pharmacol
oglcal
reglmen.
+#,- '($)*

! MalnLaln
sLable vlLal
slgns.

lndependenL:

! AccepL cllenL's
descrlpLlon of paln.
Acknowledge Lhe
paln experlence and
convey accepLance of
cllenL's response Lo
paln.


! MonlLor skln
color/LemperaLure
and vlLal slgns.



! noLe when paln
occurs (e.g., only
wlLh ambulaLlon,
every evenlng).


! rovlde comforL
measures, quleL
envlronmenL, and


! aln ls a
sub[ecLlve
experlence
and cannoL
be felL by
oLhers.



! 1hls are
usually
alLered ln
acuLe paln.


! 1o medlcaLe
prophylacLlca
lly, as
approprlaLe.


! 1o promoLe
non-
pharmacologl

AfLer 2 weeks of
nurslng
lnLervenLlon Lhe
paLlenL has been:

!"#$% '($)*

! 8eporLed
paln ls
relleved.

! lollowed
prescrlbed
pharmacolo
glcal
reglmen.
+#,- '($)*

! MalnLalned
sLable vlLal
slgns.

! verballzed














8eference:
hLLp://cmbl.b[mu.
edu.cn


! verballze
non-
pharmacol
oglc
meLhods
LhaL
provlde
rellef.

! uemonsLra
Le use of
relaxaLlon
skllls and
dlverslonal
acLlvlLles,
as
lndlcaLed,
for
lndlvldual
slLuaLlons.
calm acLlvlLles.


.(/(,0(,%*

! AdmlnlsLer
analgeslcs, as
lndlcaLed, Lo
maxlmum dosage, as
needed.






! Lncourage adequaLe
resL perlods.


! rovlde for
lndlvlduallzlng
physlcal
Lherapy/exerclse
program LhaL can be
conLlnued by Lhe
cllenL afLer dlscharge.
cal paln
managemenL
.


! 1o malnLaln
accepLable
level of paln.
noLlfy
physlclan lf
reglmen ls
lnadequaLe
Lo meeL paln
conLrol goal.


! 1o prevenL
faLlgue.


! romoLes
acLlve, noL
passlve, role
and
enhances
sense of
conLrol.
non-
pharmacolo
glc meLhods
LhaL
provlde
rellef.

! uemonsLraL
ed use of
relaxaLlon
skllls and
dlverslonal
acLlvlLles, as
lndlcaLed,
for
lndlvldual
slLuaLlons.




!"# %&'" ()**&+&
(,--./. ,0 123!41/
.C. 8ox 4437 1003 MAnlLA, PlLllnLS 1LLLlAx: 733-6011 Lo 13 Loc. 4131


7!!.!!R.1S

A47/1,!4!

37S4,17-.

B-71141/

123!41/ 41S.3T.1S4,1

37S4,17-.

.T7-27S4,1

*Su8!LC1lvL:



*C8!LC1lvL:
! vlLal slgns
Laken:

8: 140/80
1LM: 37.2C
88: 16 bpm
8: 36 bpm

lneffecLlve
Llssue
perfuslon
relaLed Lo
alLered arLerlal
blood flow as
evldence by
lncrease ln
blood pressure.

lncreased
cardlac ouLpuL
LhaL ln[ures Lhe
endoLhellal cells
of Lhe arLerles
and Lhe acLlon
of
prosLaglandlns.
vasoconsLrlcLlo
n occurs and
blood pressure
lncreases.






AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! MonlLor
sLable blood
pressure.

! verballze
undersLandl
ng abouL
Lhe proper
prevenLlon
LreaLmenLs.

+#,- '($)*

! arLlclpaLe
ln
recommend
ed
LreaLmenL
program.

1,0(/(,0(,%*

! MonlLored blood
pressure every 4
hours.


! lnsLrucLed Lo have
enough resL on seml
fowler's poslLlon.


! lnsLrucLed Lo eaL low
faL low salL dleL.




2#3345#$4%67(*

! AdmlnlsLered anLl-
hyperLenslve drug as
ordered.



! 1o know Lhe
base llne of
(8) blood
pressure.

! Sodlum Lends
Lo be excreLed
aL a fasLer raLe.


! 1o reduce
edema LhaL
may acLlvaLe
rennln
angloLensln-
aldosLerone
sysLem.

! 1o conLrol Lhe
blood pressure
and Lo avold
oLher
compllcaLlons.


AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! MonlLored
sLable blood
pressure.

! verballzed
undersLandlng
abouL Lhe
proper
prevenLlon
LreaLmenLs.

+#,- '($)*

! arLlclpaLed ln
recommended
LreaLmenL
program.
!"# %&'" ()**&+&
(,--./. ,0 123!41/
.C. 8ox 4437 1003 MAnlLA, PlLllnLS 1LLLlAx: 733-6011 Lo 13 Loc. 4131


7!!.!!R.1S

A47/1,!4!

37S4,17-.

B-71141/

123!41/
41S.3T.1S4,1

37S4,17-.

.T7-27S4,1


*Su8!LC1lvL
SumaklL blgla ang
puso ko". As
verballzed by Lhe
paLlenL.



*C8!LC1lvL

! alplLaLlon
! ChesL aln
! vlLal Slgns of:
8: 180/90
1LM: 37.2C
88: 22 bpm
8: 64 bpm

AcuLe paln
relaLed Lo
decreased
myocardlal
blood flow as
evldence by
chesL paln.

ChesL paln can
resulL from any
condlLlon ln whlch
Lhere's a decrease
ln oxygen dellvery
by Lhe coronary
arLerles, an
lncrease ln cardlac
workload, or an
lncrease ln Lhe
myocardlum's
oxygen
requlremenLs.
Sudden or slow
onseL of any
lnLenslLy from mlld
Lo severe wlLh an
anLlclpaLed or
predlcLable end
and duraLlon of less
Lhan 6 monLhs.

AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! 8eporL paln ls
relleved.

! lollow
prescrlbed
pharmacologlc
al reglmen.
+#,- '($)*

! MalnLaln sLable
vlLal slgns.

! verballze non-
pharmacologlc
meLhods LhaL
provlde rellef.

1,0(/(,0(,%*

! MonlLor skln
color/LemperaLure
and vlLal slgns.



! noLe when paln
occurs (e.g., only
wlLh ambulaLlon,
every evenlng).


! rovlde comforL
measures, quleL
envlronmenL, and
calm acLlvlLles.


! use paln raLlng
scale Lo assess Lhe
paLlenL's
percepLlon of
paln's severlLy.



! 1hls are
usually alLered
ln acuLe paln.


! 1o medlcaLe
prophylacLlcall
y, as
approprlaLe.



! 1o promoLe
non-
pharmacologl
cal paln
managemenL.

! 1o
monlLor Lhe
effecLlveness
of
medlcaLlons

AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! 8eporLed
paln ls
relleved.

! lollowed
prescrlbed
pharmacologl
cal reglmen.
+#,- '($)*

! MalnLalned
sLable vlLal
slgns.

! verballzed
non-

! uemonsLraLe
use of
relaxaLlon skllls
and dlverslonal
acLlvlLles, as
lndlcaLed, for
lndlvldual
slLuaLlons.



.(/(,0(,%*

! AdmlnlsLer
analgeslcs, as
lndlcaLed, Lo
maxlmum dosage,
as needed.






! Lncourage
adequaLe resL
perlods.


! rovlde for
lndlvlduallzlng
physlcal
Lherapy/exerclse
program LhaL can
be conLlnued by
Lhe cllenL afLer
dlscharge.
glven for paln
rellef.



! 1o malnLaln
accepLable
level of paln.
noLlfy
physlclan lf
reglmen ls
lnadequaLe Lo
meeL paln
conLrol goal.


! 1o prevenL
faLlgue.



! romoLes
acLlve, noL
passlve, role
and enhances
sense of
conLrol.
pharmacologl
c meLhods
LhaL provlde
rellef.

! uemonsLraLe
d use of
relaxaLlon
skllls and
dlverslonal
acLlvlLles, as
lndlcaLed, for
lndlvldual
slLuaLlons.



!"# %&'" ()**&+&
(,--./. ,0 123!41/
.C. 8ox 4437 1003 MAnlLA, PlLllnLS 1LLLlAx: 733-6011 Lo 13 Loc. 4131


7!!.!!R.1S

A47/1,!4!

37S4,17-.

B-71141/

123!41/ 41S.3T.1S4,1

37S4,17-.

.T7-27S4,1

*Su8!LC1lvL:
SumaklL blgla ang
puso ko." As
verballzed by Lhe
paLlenL.


*C8!LC1lvL:

! vlLal slgns
Laken:

8: 130/770
1LM: 37.4C
88: 18 bpm
8: 66 bpm

AcuLe
paln relaLed
Lo myocardlal
lschemla
secondary Lo
arLerlal
occluslon as
evldence by
chesL paln.


Cccluslon of Lhe
coronary arLery
LhaL leads Lo a
decrease blood
flow Lo Lhe
myocardlum
and decrease
oxygen supply
(lschemla) LhaL
leads Lo
anaeroblc
meLabollsm LhaL
cause lacLlc acld
formaLlon and
causes paln.






AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! verballze
conLrol of chesL
paln wlLhln
approprlaLe
Llme frame for
admlnlsLered
medlcaLlons.

! lollow
prescrlbed
pharmacologlc
al reglmen.
+#,- '($)*

! MalnLaln sLable
vlLal slgns.

! verballze non-
pharmacologlc

1,0(/(,0(,%*

! CbLaln full
descrlpLlon of paln
from paLlenL
lncludlng locaLlon,
lnLenslLy (0-10),
duraLlon,
characLerlsLlcs
(dull/crushlng), and
radlaLlon. AsslsL
paLlenL Lo quanLlfy
paln by comparlng lL
Lo oLher
experlences.


! lnsLrucL paLlenL Lo
reporL paln
lmmedlaLely.









! aln ls a
sub[ecLlve
experlence
and musL be
descrlbed by
paLlenL.









! uelay ln
reporLlng
paln hlnders
paln
rellef/may
requlres
lncreased
dosage of
medlcaLlon

AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! verballzed
conLrol of chesL
paln wlLhln
approprlaLe
Llme frame for
admlnlsLered
medlcaLlons.

! lollowed
prescrlbed
pharmacologlc
al reglmen.
+#,- '($)*

! MalnLalned
sLable vlLal
slgns.

! verballzed
meLhods LhaL
provlde rellef.

! uemonsLraLe
use of
relaxaLlon skllls
and dlverslonal
acLlvlLles, as
lndlcaLed, for
lndlvldual
slLuaLlons.




! rovlde quleL
envlronmenL, calm
acLlvlLles, and
comforL measures.











! AsslsL/lnsLrucL ln
relaxaLlon
Lechnlques, e.g.,
deep/slow
breaLhlng,
dlsLracLlon
behavlors,
vlsuallzaLlon, gulded
lmagery.






Lo achleve
rellef.


! uecreases
exLernal
sLlmull,
whlch may
aggravaLe
anxleLy and
cardlac
sLraln, llmlL
coplng
ablllLles and
ad[usLmenL
Lo currenL
slLuaLlon.


! Pelpful ln
decreaslng
percepLlon
of/response
Lo paln.
rovldes a
sense of
havlng some
conLrol over
Lhe slLuaLlon,
lncrease ln
poslLlve
aLLlLude.


non-
pharmacologlc
meLhods LhaL
provlde rellef.

! uemonsLraLed
use of
relaxaLlon skllls
and dlverslonal
acLlvlLles, as
lndlcaLed, for
lndlvldual
slLuaLlons.
2#3345#$4%67(*

! AdmlnlsLer
supplemenLal
oxygen by means of
nasal cannula or
face mask, as
lndlcaLed.








! AdmlnlsLer
analgeslcs, as
lndlcaLed, Lo
maxlmum dosage,
as needed.



! lncreases
amounL of
oxygen
avallable for
myocardlal
upLake and
Lhereby may
relleve
dlscomforL
assoclaLed
wlLh Llssue
lschemla.


! useful Lo
conLrol/rellev
e paln.








!"# %&'" ()**&+&
(,--./. ,0 123!41/
.C. 8ox 4437 1003 MAnlLA, PlLllnLS 1LLLlAx: 733-6011 Lo 13 Loc. 4131


7!!.!!R.1S

A47/1,!4!

37S4,17-.

B-71141/

123!41/ 41S.3T.1S4,1

37S4,17-.

.T7-27S4,1

*Su8!LC1lvL:
SumaklL blgla ang
puso ko." As
verballzed by Lhe
paLlenL.


*C8!LC1lvL:

! PyperLenslon
! vlLal slgns
Laken:

8: 130/80
1LM: 37.4C
88: 20 bpm
8: 60 bpm

AcLlvlLy
lnLolerance
relaLed Lo
oxygen
supply/demand
lmbalances as
evldence by
hyperLenslon.

PyperLenslon
occurs due Lo
Lhe abnormal
funcLlonlng of
Lhe arLerlal
pressure
relaLed Lo Lhe
cenLral nervous
sysLem, renln-
angloLensln-
aldosLerone
sysLem,
endoLhellal
dysfuncLlon,
genes and even
due Lo cerLaln
envlronmenLal
facLors.









AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:


!"#$% '($)*

! MonlLor
normal
blood
pressure.

! lollow
prescrlbed
pharmacolo
glcal
reglmen Lo
decrease
blood
pressure.


+#,- '($)*


1,0(/(,0(,%*

! noLe presence of
facLors conLrlbuLlng
Lo faLlgue.






! noLe cllenL reporLs
of weakness, faLlgue,
paln, dlfflculLy
accompllshlng Lask,
and /or lnsomnla.




! rovlde poslLlve
aLmosphere, whlle
acknowledglng
dlfflculLy of Lhe
slLuaLlon for Lhe
cllenL.



! laLlgue affecLs
boLh cllenL's,
acLual and
percelved
ablllLy Lo
parLlclpaLe ln
acLlvlLles.


! SympLoms
maybe resulL
of/or
conLrlbuLe Lo
lnLolerance of
acLlvlLy.



! Pelps mlnlmlze
frusLraLlon and
re-channel
energy.



AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! MonlLored
normal blood
pressure.

! lollowed
prescrlbed
pharmacologlc
al reglmen Lo
decrease
blood
pressure.
+#,- '($)*

! MalnLalned
sLable vlLal
slgns.

! verballzed


















8eference:
8uzzle: hLLp://
www.buzzle.co
m/arLlcles/paLh
ophyslology-of-
hyperLenslon.h
Lml



! MalnLaln
sLable vlLal
slgns.


! verballze
non-
pharmacolo
glc meLhods
LhaL provlde
rellef.

! uemonsLraL
e use of
relaxaLlon
skllls and
dlverslonal
acLlvlLles, as
lndlcaLed,
for
lndlvldual
slLuaLlons.


! rovlde comforL
measures and
provlde for rellef of
paln.


2#3345#$4%67(*

! rovlde medlcaLlons
LhaL relleve/conLrols
lncrease ln blood
pressure.


! 1o enhance
ablllLy Lo
parLlclpaLe ln
acLlvlLles.




! 1o provlde
comforL Lo Lhe
cllenL.
non-
pharmacologlc
meLhods LhaL
provlde rellef.

! uemonsLraLed
use of
relaxaLlon
skllls and
dlverslonal
acLlvlLles, as
lndlcaLed, for
lndlvldual
slLuaLlons.



!"# %&'" ()**&+&
(,--./. ,0 123!41/
.C. 8ox 4437 1003 MAnlLA, PlLllnLS 1LLLlAx: 733-6011 Lo 13 Loc. 4131


7!!.!!R.1S

A47/1,!4!

37S4,17-.

B-71141/

123!41/ 41S.3T.1S4,1

37S4,17-.

.T7-27S4,1

*Su8!LC1lvL:
SumaklL blgla ang
puso ko." As
verballzed by Lhe
paLlenL.


*C8!LC1lvL:

! LefL
venLrlcular
PyperLrophy
! vlLal slgns
Laken:

8: 130/70
1LM: 37.4 C
88: 18 bpm
8: 66 bpm

uecreased
cardlac ouLpuL
relaLed Lo
pump fallure
of Lhe lefL
venLrlcle as
evldence by
hyperLrophy
and chesL
paln.

ump fallure Lhe
hearL as a pump
ls unable Lo meeL
Lhe meLabollc
requlremenLs of
Lhe Llssue for
oxygen and
subsLraLes
desplLe Lhe
venous reLurn Lo
hearL are elLher
normal or
lncreased.




AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! verballze
conLrol of
chesL paln
wlLhln
approprlaLe
Llme frame
for
admlnlsLered
medlcaLlons.

! lollow
prescrlbed
pharmacologl
cal reglmen.
+#,- '($)*

! MalnLaln
sLable vlLal
slgns.

1,0(/(,0(,%*

! MonlLor blood
pressure.







! MonlLor skln
color/LemperaLure
and vlLal slgns.



! lnsLrucL paLlenL Lo
reporL paln
lmmedlaLely.









! 1he body could
no longer
compensaLe
and
hypoLenslon
cannoL be
normal agaln.


! 1hls are usually
alLered ln acuLe
paln.



! uelay ln
reporLlng paln
hlnders paln
rellef/may
requlres
lncreased
dosage of
medlcaLlon Lo
achleve rellef.

AfLer 2 weeks of
nurslng lnLervenLlon
Lhe paLlenL wlll:

!"#$% '($)*

! verballzed
conLrol of
chesL paln
wlLhln
approprlaLe
Llme frame for
admlnlsLered
medlcaLlons.

! lollowed
prescrlbed
pharmacologl
cal reglmen.
+#,- '($)*

! MalnLalned
sLable vlLal
slgns.


! verballze
non-
pharmacologl
c meLhods
LhaL provlde
rellef.

! uemonsLraLe
use of
relaxaLlon
skllls and
dlverslonal
acLlvlLles, as
lndlcaLed, for
lndlvldual
slLuaLlons.

! 8ecord Lhe hearL
sounds.










! rovlde quleL
envlronmenL, calm
acLlvlLles, and
comforL measures.









! AsslsL/lnsLrucL ln
relaxaLlon
Lechnlques, e.g.,
deep/slow
breaLhlng,
dlsLracLlon
behavlors,
vlsuallzaLlon, gulded

! S1 and S2 may
be weak due Lo
decreased
pumplng
acLlon. Mur-
mur may
lndlcaLe
lncompeLence /
sLenosls of Lhe
valve.


! uecreases
exLernal sLlmull,
whlch may
aggravaLe
anxleLy and
cardlac sLraln,
llmlL coplng
ablllLles and
ad[usLmenL Lo
currenL
slLuaLlon.


! Pelpful ln
decreaslng
percepLlon
of/response Lo
paln. rovldes a
sense of havlng
some conLrol
over Lhe
! verballzed
non-
pharmacologl
c meLhods
LhaL provlde
rellef.

! uemonsLraLed
use of
relaxaLlon
skllls and
dlverslonal
acLlvlLles, as
lndlcaLed, for
lndlvldual
slLuaLlons.
lmagery.





2#3345#$4%67(*

! AdmlnlsLer
supplemenLal
oxygen by means of
nasal cannula or
face mask, as
lndlcaLed.







! AdmlnlsLer
analgeslcs, as
lndlcaLed, Lo
maxlmum dosage,
as needed.

slLuaLlon,
lncrease ln
poslLlve
aLLlLude.




! lncreases
amounL of
oxygen
avallable for
myocardlal
upLake and
Lhereby may
relleve
dlscomforL
assoclaLed wlLh
Llssue lschemla.


! useful Lo
conLrol/relleve
paln.