Which of the following symptoms should the nurse teach the client with unstable angina to report immediately to her physician?
A. A change in the pattern of her pain.
B. Pain during sex.
C. Pain during an argument with her husband.
D. Pain during or after an activity such as lawn mowing.
Correct Answer: A. A change in the pattern of her pain
The client should report a change in the pattern of chest pain. It may indicate an increasing severity of CAD. This is important to note as these differences may indicate impending myocardial infarction, and ST-elevation myocardial infarction (STEMI) and should be evaluated expeditiously as the risk of morbidity and mortality are higher in this scenario versus stable angina.
Option B: Patients will often present with chest pain, shortness of breath. The chest pain will often be described as pressure-like, although it is not necessarily limited to this description. Tightness, burning, sharp types of pain can be described. Often patients will report discomfort as opposed to actual pain.
Option C: One distinguishing factor of unstable angina is that the pain may not completely resolve with these reported relieving factors. Also, many patients will already have coronary artery disease. This may be either established coronary artery disease or symptoms they have been experiencing for some time. These patients may have familiarity with the symptoms and may report an increase in episodes of chest pain that takes longer to resolve and an increase in the severity of symptoms.
Option D: The pain will often radiate to the jaw or arms, both left and right sides can be affected. Constitutional symptoms such as nausea, vomiting, diaphoresis, dizziness, and palpitations may also be present. Exertion may worsen pain and rest can ease the pain. Nitroglycerin and aspirin administration may also improve the pain.
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