EMERGENCY CARE NURSING
TO CLIENTS WITH CHEST PAIN
A. DEFINITIONS· Chest pain is feeling pain / annoying uncomfortable chest area and often the pain is projected on the chest wall (Referred pain)· Coroner Pain is pain due to myocardial ischemia due to coronary blood flow supply at a time is not sufficient for the needs of myocardial metabolism.· Chest pain due to lung diseases such as inflammation of the pleura (pleurisy) because the lung lining that can be a source of pain, while the visceral pleura and lung parenchyma painless (Hima, 1996)
B. EtiologyChest Pain:a. Cardial- Coroner- Non-Coronaryb. Non cardial- Pleural- Gastrointestinal- Neural- Psychogenic (Abdurrahman N, 1999)C. SIGNS AND SYMPTOMSSigns and symptoms of chest pain which accompanies are:- Heartburn- Headache- Pain is projected to arms, neck, back- Diaphoresis / cold sweat- Shortness of breath- Tachycardia- Pale skin- Difficulty sleeping (insomnia)- Nausea, Vomiting, Anorexia- Anxiety, restlessness, focus on yourself- Weakness- The face tense, m erintih, crying- Changes in consciousness
D. EXAMINATION SUPPORTa. 12 lead ECG during pain episodes- Takhikardi / dysrhythmias- Record full ECG: inverted T, ST elevation / depression, pathological Qb. Laboratory- Levels of cardiac enzymes: CK, CKMB, LDH- Liver function: SGOT, SGPT- Kidney function: urea, creatinine- Lipid Profile: LDL, HDLc. Photo Thoraxd. Echocardiographice. Cardiac catheterizationE. PATHWAY
F. ASSESSMENT1. Primary Assessmenta. Airway- How airway patency- Is there a blockage / accumulation of secretions in the airway?- How does the sound of his breathing, if there are additional breath sounds?
b. Breathing- How breathing pattern? Frequency? Depth and rhythm?- Aapakah using accessory muscles of respiration?- Are there additional breath sounds?c. Circulation- What about the peripheral arteries and the carotid pulse? Quality (content and voltage)- How Capillary refillnya, if there akral cold, cyanosis or oliguri?- Is there a loss of consciousness?- How vital signs? T, S, N, RR, HR?
2. Secondary AssessmentImportant things that need to be studied further in chest pain (coronary):a. Location of painWhere to place the start, penjalarannya (coronary chest pain: from sternal spread to the neck, chin or shoulder to left forearm ulna)b. Nature of the painFeeling of fullness, heaviness such as seizures, squeezing, stabbing, choking / burning, etc..c. Characteristics of painDegree of pain, duration, number of times within a certain period incurred.d. Chronology of painEarly pain relief and progress sequentiallyH. INTERVENTIONPrinciples of action:1. Bed rest (bed rest) with Fowler position / semi-Fowler2. Perform a 12 lead ECG that need 24 leads3. Observing vital signs4. Collaboration of O2 and administration of drugs analgesic, sedative, nitroglycerin, calcium antagonists and observation of drug side effects.5. Installing a drip and give peace to the client6. Taking blood samples7. Reduce environmental stimuli8. Be calm in the works9. Observe signs of complications
REFERENCES
1. Abdurrahman, N, History and examination Cardiovascular System in IPD Physical Volume I, Jakarta: Faculty of Medicine, 1999.2. Doenges, Marilynn E, Nursing Care Plan, Jakarta: EGC, 2000.3. Hima, Cardiovascular System Disorders Study Books, 1994.4. Hudak & Gallo, Critical Nursing mold I, Jakarta: EGC, 1995
TO CLIENTS WITH CHEST PAIN
A. DEFINITIONS· Chest pain is feeling pain / annoying uncomfortable chest area and often the pain is projected on the chest wall (Referred pain)· Coroner Pain is pain due to myocardial ischemia due to coronary blood flow supply at a time is not sufficient for the needs of myocardial metabolism.· Chest pain due to lung diseases such as inflammation of the pleura (pleurisy) because the lung lining that can be a source of pain, while the visceral pleura and lung parenchyma painless (Hima, 1996)
B. EtiologyChest Pain:a. Cardial- Coroner- Non-Coronaryb. Non cardial- Pleural- Gastrointestinal- Neural- Psychogenic (Abdurrahman N, 1999)C. SIGNS AND SYMPTOMSSigns and symptoms of chest pain which accompanies are:- Heartburn- Headache- Pain is projected to arms, neck, back- Diaphoresis / cold sweat- Shortness of breath- Tachycardia- Pale skin- Difficulty sleeping (insomnia)- Nausea, Vomiting, Anorexia- Anxiety, restlessness, focus on yourself- Weakness- The face tense, m erintih, crying- Changes in consciousness
D. EXAMINATION SUPPORTa. 12 lead ECG during pain episodes- Takhikardi / dysrhythmias- Record full ECG: inverted T, ST elevation / depression, pathological Qb. Laboratory- Levels of cardiac enzymes: CK, CKMB, LDH- Liver function: SGOT, SGPT- Kidney function: urea, creatinine- Lipid Profile: LDL, HDLc. Photo Thoraxd. Echocardiographice. Cardiac catheterizationE. PATHWAY
F. ASSESSMENT1. Primary Assessmenta. Airway- How airway patency- Is there a blockage / accumulation of secretions in the airway?- How does the sound of his breathing, if there are additional breath sounds?
b. Breathing- How breathing pattern? Frequency? Depth and rhythm?- Aapakah using accessory muscles of respiration?- Are there additional breath sounds?c. Circulation- What about the peripheral arteries and the carotid pulse? Quality (content and voltage)- How Capillary refillnya, if there akral cold, cyanosis or oliguri?- Is there a loss of consciousness?- How vital signs? T, S, N, RR, HR?
2. Secondary AssessmentImportant things that need to be studied further in chest pain (coronary):a. Location of painWhere to place the start, penjalarannya (coronary chest pain: from sternal spread to the neck, chin or shoulder to left forearm ulna)b. Nature of the painFeeling of fullness, heaviness such as seizures, squeezing, stabbing, choking / burning, etc..c. Characteristics of painDegree of pain, duration, number of times within a certain period incurred.d. Chronology of painEarly pain relief and progress sequentiallyH. INTERVENTIONPrinciples of action:1. Bed rest (bed rest) with Fowler position / semi-Fowler2. Perform a 12 lead ECG that need 24 leads3. Observing vital signs4. Collaboration of O2 and administration of drugs analgesic, sedative, nitroglycerin, calcium antagonists and observation of drug side effects.5. Installing a drip and give peace to the client6. Taking blood samples7. Reduce environmental stimuli8. Be calm in the works9. Observe signs of complications
REFERENCES
1. Abdurrahman, N, History and examination Cardiovascular System in IPD Physical Volume I, Jakarta: Faculty of Medicine, 1999.2. Doenges, Marilynn E, Nursing Care Plan, Jakarta: EGC, 2000.3. Hima, Cardiovascular System Disorders Study Books, 1994.4. Hudak & Gallo, Critical Nursing mold I, Jakarta: EGC, 1995
