Year: 2015

Description:– It is commonly known as Angina; is chest pain often due to Ischemia of the heart muscle , due in general to obstruction or spasm of the coronary Arteries.
The term derives from the Latin Angina (infection of the throat) and the Latin pectus (Chest) and can therefore, be translated as “a strangling feeling in the chest”
There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle
Classification:- the angina pectoris has classified under 2 category that is-
1) Stable Angina
2) Unstable Angina

1) Stable Angina:- Also known as effort Angina, this refers to the more common understanding of angina related to Myocardial Ischemia. Typicl presentation of stable angina is that of chest discomfort and associated symptions precipitated by some activity (running, walking, etc) with minimal or non existent symptoms at rest or with administration of sublingual nitroglycerin. Symptoms typically abate several minutes following cessation of precipitating activities and recur when activity resumes. In this way, stable angina may be thought of as being similar to intermittent claudication symptoms.

2) Unstable Angina(UA):- It is define ass angina pectoris that changes or worsens .
It has at least one of these 3 features:
a) It occur at rest, usually lasting 3-5 min. is severe and of new onset(i.e., within the prior 4-6 weeks)
b) It occur with a crescendo pattern(i.e., distinctly more severe prolonged or frequent than before)
c) It may occur unpredictably at rest, which may be a serious indicator of an impending heart attack.
The pathophysiology of UA is the reduction of coronary flow due to transient platelet aggregation on apparently normal endothelium, coronary artery spasms or coronary thrombosis
Cause:-
1). Major risk factors; > Age(> 55 year for men, > 65 for women)
> Cigarette smoking
> Diabetes mellitus
> Family history of premature cardiovascular disease
> Hypertension
– kidney disease
2) Other medical problems;
Profound Anemia, uncontrolled Hypertension, Hyperthyroidism and hypoxemia

Signs and symptoms:- Angina pectoris can be quite painful, but many patients with angina complain of chest discomport rather than actual pain
The discompert is usually described as:-
A pressure, heaviness, tightness, squeezing, burning, or choking sensation
– In this case , the BP and pulse rate increases
– Myocardial ischemia
– Autonomic Symptoms like nausea
– , vomiting, and pallor
Major risk factors Angina pectoris:-
1) Smoking,
2) Diabetes,
3) High cholesterol,
4) High BP,
5) Sedentary lifestyle and
6) Family history of premature heart diseases

Treatment:-
 The most specific medicine to treat Angina is NITROGLYCERIN.
 Balloon Angioplasty
 Coronary bypass surgery
 Beta blocker (atenolol,propranolol)
 Calcium channel blockers (nifedipine,amlodipine)

Definition:-
It may be define as administration of blood &blood components by iv route. It is known as blood transfusion.
Pre transfusion assessment:-

1. Patients history:-
Collect the patients history about previous transfusionor as well as previous reaction to transfusion.
2. Physical assessment:-
A baseline vital sign are important before transfusion of the blood.
3. Preparation of the patient environment:-
a. Explain the procedure to the patient
b. Provide the food & fluid as patient need .
c. Assess or note the vital sign of the patient .
d. Provide comfortable position
e. Clear all the doubts of the patients well as family member regarding blood transfusion.
f. Maintain the proper lighting.
Selection of the donor:-
1. Donor should be free from the infectious disease.
2. Vital sign should be normal
3. He did not given blood from last 3 months
4. Hb level should be normal
5. Blood cross matching should be done
Selection of the receiver:-
1. Assess the blood group.
2. Note the vital sign
Procedure:-
1. Wash the hands
2. Confirm the transfusion had been prescribed
3. Check the patient for blood grouping verify that patient has sign a written consent form as per as agency policy.
4. Explain the procedure to the patient
5. Instruct the patient about sign & symptoms during transfusion such as nausea , vomiting etc.
6. Monitor vital sign use hand hygiene & wear gloves .
7. Set the blood bottles on iv poles
8. Fix the cannula in the vein
9. Connect the cannula from blood set
10. Monitor vital sign throughout the transfusion. If there is any changes in transfusion or allergic reaction then,
a. Stop the transfusion
b. Inform the dutry doctor
c. Keep ready loaded inj.dexomethasone & avil.
After the complete of transfusion remove the iv line or set 7 press the vein with cotton.
After blood transfusion record & report should be maintain by the nurse it incluse:-
a. Type of blood which is transfused
b. Amount of blood
c. Flow rate of the transfusion
d. Any reaction which occur during the procedure.
e. Name of the donor
f. Written consent for medicolegal purpose.