The nurse knows that the basic strategies of antianginal therapy are
1. decreased oxygen consumption of the brain.
2. increased myocardial contractility.
3. increased blood flow to the peripheral blood vessels.
4. increased blood flow to the myocardium.
5. decreased myocardial oxygen demand.
4,5
Rationale 1: Decreasing brain oxygen consumption will not help correct this problem.
Rationale 2: Increasing contractility will increase myocardial oxygen supply, making the angina worse.
Rationale 3: Increasing blood flow to peripheral blood vessels does nothing to correct this imbalance.
Rationale 4: Angina is a mismatch between myocardial oxygen supply and oxygen demand. A basic antianginal strategy is to increase oxygen supply by increasing blood flow to the coronary arteries.
Rationale 5: Angina is a mismatch between myocardial oxygen supply and oxygen demand. A basic antianginal strategy is to decrease myocardial oxygen demand.
Global Rationale: Angina is a mismatch between myocardial oxygen supply and oxygen demand. Basic antianginal strategies are to increase oxygen supply by increasing blood flow to the coronary arteries or to decrease myocardial oxygen demand. Decreasing brain oxygen consumption will not help correct this problem. Increasing contractility will increase myocardial oxygen supply, making the angina worse. Increasing blood flow to peripheral blood vessels does nothing to correct this imbalance.
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