Atherosclerosis

Hardening and narrowing of the arteries .This progressive process silently and
slowly blocks arteries, putting blood flow at risk.
Atherosclerosis is the usual cause of heart attacks, strokes, and peripheral vascular
disease, what together are called "cardiovascular disease."
Etiology

Unhealthy blood cholesterol levels

High blood pressure
Smoking
Diabetes
Being overweight or obese
Lack of physical activity
Poor diet
Some risk factors you cannot control. Risk factors you cannot control include:
Old age
Family history

Pathophysiology
Plaque build-up and subsequent hardening of the arteries restricts blood flow in the
arteries, preventing your organs and tissues from getting the oxygenated blood
they need to function.
Signs and Symptoms

Chest pain or discomfort called angina

Shortness of breath
Abnormal heart beat
Confusion
Dizziness, loss of balance or coordination
Inability to move
Loss of consciousness
Numbness of the face, arms, or legs, especially on one side of the body
Problems breathing
Sudden and severe headache
Sudden weakness
Trouble seeing
Trouble speaking or understanding speech

Diagnostic Procedure/ Laboratory

a blood test to check your cholesterol levels

a Doppler ultrasound, which uses sound waves to create a picture of the
artery that shows if there is a blockage
ankle-brachial test, which compares the blood pressure in your arms and legs
to look for a blockage in your arms or legs

magnetic resonance arteriography (MRA) or computed tomography (CT)

angiography to create pictures of the large arteries in your body
cardiac angiogram, which requires an injection of radioactive dye that can be
seen on X-rays to create a picture of the arteries in your heart
an electrocardiogram (ECG), which measures the electrical activity in your
heart to look for any areas of decreased blood flow
a stress test (exercise tolerance test), which monitors your heart rate and
blood pressure while you exercise on a treadmill or stationary bicycle

Nursing Diagnosis

Acute Pain related to impaired ability of blood vessels to supply oxygen to the
tissues.

Nursing Management
1. Monitor the characteristics of pain through verbal response, and hemodynamics
(crying, pain, grimacing, can not rest, respiratory rhythm, blood pressure and
changes in heat rate).
2. Assess the picture of pain experienced by patients include: place, intensity,
duration, quality, and distribution.
3. Provide a comfortable environment, reduce the activity, limit visitors.
4. Teach relaxation techniques with a deep breath
5. Observation of vital signs before and after drug administration.
Medical Managements

bypass surgery: a vessel from elsewhere in the body, or a synthetic tube, is

used for diverting blood around a blocked or narrowed artery
thrombolytic therapy: dissolves a blood clot by injecting a drug into the
affected artery
angioplasty: a thin, flexible tube called a catheter and balloon are used to
expand an artery
endarterectomy: surgically removing fatty deposits from an artery
atherectomy: a nonsurgical procedure that removes plaque from the arteries
using a catheter with a sharp blade at one end

Medical treatments

Clopidogrel (Plavix): prevent clots from forming inside stents placed in the
heart's arteries.
Warfarin- anticoagulant
Niacin
Fibrates, such as gemfibrozil (Lopid) and fenofibrate (Tricor)
Cholesterol-absorption inhibitor, such as ezetimibe (Zetia)

Reference: Medical-Surgical Nursing page 826