NURSING IN HEART

DISEASE CORONARY

GROUP 2C

NAME OF GROUP 2C
OKTIANINGSIH EKA W.
RENNI DWI RAHAYU
RIZKA LUTFIANITA
SITI MAKHMUDAH
SRI RAHAYU
TAUFIK KADARUSMAN
TIKA APRILIANI
TITIK RAHMAWANTI
YESIKA GARBELLA S.
YOVIN BETA FADHYA
ZAENAB KARTIKA B.
ZAIM AFIFUDDIN FASYA

A11501175
A11501179
A11501184
A11501193
A11501198
A11501206
A11501207
A11501208
A11501218
A11501219
A11501221
A11501222
GROUP 2C S1 KEP 2016

DEFINITION
Coronary heart disease (CHD) is a state where there
is an imbalance between the needs of the heart
muscle with oxygen over a given supply of coronary
arteries. Inability to coronary blood vessels to supply
oxygen is usually caused by a blockage athroma
(plaque) on the inner walls of the coronary arteries.
(Abdul Majid, 2007).

GROUP 2C S1 KEP 2016

ETIOLOGY
The most common cause CHD income is reduced blood to the heart
muscle caused by a blockage mindless and thrombus in coronary artery
disease in the area near the atherosclerotic, because the resulting

GROUP 2C S1 KEP 2016

pathophysiological
a. The occurrence of CHD associated with a disorder of the blood
vessels called arteriosklelorosis.
b. This translates into rigidity and narrowing of blood vessels
holes which will cause a distraction or lack of blood supply to
the heart muscle.
c. This situation will lead to what is called myocardial ischemia
d. Angina pectoris occurs as a result of their underlying fissure
plaque or thrombus formation. Ischemic episode caused by
thrombus total occlusion in intermittent or emboli distal
section composed by pallets and cholesterol regardless of
plaque
e. Acute myocardial infarction caused by occlusion of the
coronary resulting in myocardial necrosis due to interruption of
blood supply is very less
GROUP 2C S1 KEP 2016

GROUP 2C S1 KEP 2016

CLINICAL
1.
2.
3.
4.
5.

Chest pain
Out of breath
Nauseous vomit
Anorexia
weak

GROUP 2C S1 KEP 2016

RISK FACTOR
Factors that can not be modified
a. Genetic factors = diabetes, hypertension,
atherosclerosis.
b. The age factor = Most occur in those aged> 65
c. factors genre
d. Hereditary factors of race and

GROUP 2C S1 KEP 2016

Factors that can be modified

a. Increased serum fat
b. Hypertension
c. Smoke
d. obesity
e. Increased serum cholesterol
f. Stress in everyday life
g. Lack of exercise
h. Use of certain medications: progestins,
corticosteroids
GROUP 2C S1 KEP 2016

MANAGEMENT
Risk factor modification
1.site unchanged smoke
2.Adjusting your diet
3.Reduce stress
4.Maintain a healthy weight
5.Surgery
6.Transplant

GROUP 2C S1 KEP 2016

DIET
1.Low fat
2.rich in fiber
3.Green vegetable
4.Fruits rich in vitamin C
5.Rich in omega-3 fatty acids
6.Avoid fast food
GROUP 2C S1 KEP 2016

Lifestyle Changes
down
k
a
n
weight

- DIET -

S
T
O
P
smoke

though
sports
tera
tour

multiply the fruit-vegetable

low salt
low cholesterol
saturated fat

manage st re s

reduce alcohol

GROUP 2C S1 KEP 2016

DIAGNOSTIC
1. Patient's medical history
2. An electrocardiogram (ECG)
3. Echocardiograhy
4. Laboratory tests
5. X-ray
6. Angiocardiografi
7. Keteterisasi cardiac and coronary
arteriography

GROUP 2C S1 KEP 2016

CASE MODULE 3
TN.P (40 Tear) Treated in Hospital karena
chest pain, pain radiating to the back and
arms, palpitations, cold sweat diaforensis,
Nausea, vomiting, weakness, love masathe
material shrimp and meat, consume alcohol
since 5 years ago.

GROUP 2C S1 KEP 2016

NURSING CARE
IDENTITY
Name
: Mr. P
Age
: 40 year
Gender
: Man
Religion
: Islam
Work
: traders
Education
: SD
Address
: Kebumen
medical diagnosis
: CHD
GROUP 2C S1 KEP 2016

MEDICAL HISTORY
1. MAIN COMPLAINT
Patients complain of chest pain that radiates to the back and arm
2. DISEASE HISTORY NOW
Patients coming to the emergency department with chest pain,
pain radiating to the back and arms, heart palpitations, cold
sweat, nausea, vomiting, weakness, like dishes made from
shrimp and meat, consume alcohol since 5 years agoTD:
150/110, N: 102 x / mnit, RR: 28x / mnit, S: 37 C
3. PAST MEDICAL HISTORY
Patient said she had never experienced a disease like this before
4. HISTORY OF DISEASE family aA
The family says no disease like this

GROUP 2C S1 KEP 2016

FOCUS ASSESSMENT
oxygenation pattern
before the pain Patients can breathe normally and no using tools
respirator
When examined : Patient feel faint (RR 28x / min)
NUTRITIONAL PATTERN
before the pain Patients say like dishes made from shrimp and meat and
consuming alcohol since 5 years ago.
When examined Patients say no appetite, feeling of nausea and vomiting
ACTIVITY
before the pain
When dikaji

Patients can perform the activity without any interruption.

: The patient feels no limitations in the move because he felt weak.

GROUP 2C S1 KEP 2016

FOCUS ASSESSMENT
NEED REST AND SLEEP
before the pain Patients can rest comfortably 7-8 hours a day
When examined : Nighttime sometimes awakened by chest pain.
NEED FOR SECURITY AND COMFORTABLE
before the pain Patients feel safe and comfortable if a state of calm
When examined : Patients complain of discomfort because of shortness of
breath, chest pain that radiates to the back and the shoulders and
heart palpitations
NEED TO LEARN
before Pain
Patients do not know about the disease
When examined Patients do not know about the disease seemed still ask the
nurse Tenya

PHYSICAL EXAMINATION
a. LUNG:
Inspection
Breasts symmetrical shape
Looks RR 28x / minute
palpation
No vocal fremitus
No tenderness

b. HEART:
Inspection
Ictus cordis Looks
palpation
Ictus cordis Palpable
Percussionthere Cardiomegaly
auscultation
BJ I / II Pure irregularity

Percussion
sonor
auscultation
No sound wheezing

GROUP 2C S1 KEP 2016

NURSING DIAGNOSES
1. Decreased tissue perfusion bd heart coronary artery spasm
2. Pain I bd injury biological agents (Cardiac tissue ischemia
or blockage of the coronary arteries)
3. Activity intolerance bd imbalance of oxygen supply and
needs
4. Deficiency of knowledge bd less information about the
disease CHD

INTERVENTION

INTERVENTI
ON

THANK YOU