INEFFECTIVE TISSUE PERFUSION (CORONARY)

Ineffective Tissue Perfusion: Coronary related to impaired Myocardial Oxygenation

Nursing Assessment	Nursing Diagnosis	Goal	Nursing Intervention	Rationale	Evaluation
Subjective Data: Chest pain or angina Shortness of breath Fatigue or weakness Palpitations Diaphoresis Nausea Anxiety or sense of impending doom Objective Data: Pale, cool, clammy skin Tachycardia or bradycardia Decreased blood pressure ECG changes (e.g., ST elevation, T-wave inversion) Decreased oxygen saturation Presence of cardiac murmurs Elevated cardiac biomarkers (e.g., troponin) Diminished peripheral pulses Prolonged capillary refill time Abnormal ABG results (e.g., hypoxia) Echocardiography showing reduced coronary perfusion	Ineffective Tissue Perfusion: Coronary related to impaired Myocardial Oxygenation	Client achieves adequate coronary tissue perfusion with stable vital signs and absence of chest pain	Assess vital signs and hemodynamic parameters (e.g., BP, HR, SpO2) frequently	To monitor perfusion status and detect changes promptly	Client demonstrates improved coronary perfusion as evidenced by stable vital signs, absence of chest pain, and normal ECG findings
			Monitor ECG continuously for changes	To identify ischemia or arrhythmias requiring immediate intervention
			Administer supplemental oxygen as prescribed	To increase oxygen supply to the myocardium
			Administer nitroglycerin as prescribed	To dilate coronary arteries and improve blood flow
			Administer antiplatelet or anticoagulant therapy (e.g., aspirin, heparin) as prescribed	To prevent thrombus formation and enhance perfusion
			Monitor for chest pain characteristics and response to interventions	To evaluate effectiveness of treatment and detect worsening ischemia
			Position client in semi-Fowler’s position	To reduce myocardial oxygen demand and improve lung expansion
			Administer beta-blockers or calcium channel blockers as prescribed	To reduce heart rate and myocardial oxygen demand
			Monitor cardiac biomarkers (e.g., troponin, CK-MB)	To assess for myocardial damage and guide treatment
			Encourage rest and limit physical activity	To decrease myocardial oxygen consumption
			Prepare client for diagnostic or interventional procedures (e.g., cardiac catheterization)	To identify and treat coronary artery blockages
			Provide emotional support and education to reduce anxiety	To minimize stress-induced increases in myocardial oxygen demand

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