Nur 2900 | Management of the Adult with Acute and Chronic
Cardiovascular Disorders Study Guide 2025/2026
Molloy College
The Barbara H. Hagan School of Nursing
Nur 2900
Dr. D. Kantor
Topic: Management of the Adult with Acute and Chronic Cardiovascular Disorders
Classroom Learning Objectives:
After completing the required learning activities and participating in classroom activities, the student
will:
1. Utilize the nursing process as a framework for the care of patients who have acute and chronic
cardiovascular disorders.
2. Describe risk factors associated with the development of acute and chronic cardiovascular
disorders.
3. Describe the pathophysiology of acute and chronic cardiovascular disorders..
4. Discuss clinical manifestations, diagnostic studies and collaborative treatment modalities for
patients who have acute and chronic cardiovascular disorders.
5. Discuss the role of the nurse with respect to the treatment of the patient who has acute and
chronic cardiovascular disorders.
6. Provide age appropriate, evidenced-based nursing interventions for the patients who have
acute and chronic cardiovascular disorders.
,DK 7/20
Molloy College
The Barbara H. Hagan School of Nursing
Nur 2900
Dr. D. Kantor
Acute and Chronic Cardiovascular Disorders
1. Angina
Overview: Chest pain due to myocardial ischemia as a result of insufficient oxygen supply to the heart.
Due to atherosclerosis or a blood clot.
The decrease in oxygen and blood supply to the heart leads to changes in cellular metabolism which
results in angina.
On the cellular level, the myocardium becomes hypoxic within the first 10 seconds of coronary
occlusion and with total occlusion of coronary arteries, contractility ceases after several minutes
leading the deprivation of oxygen and glucose for aerobic metabolism to myocardial cells. Anaerobic
metabolism begins and lactic acid accumulates. Lactic acid irritates myocardial nerve fibers and
transmits a pain message to the cardiac nerves and upper thoracic posterior nerve roots. This accounts
for the referred cardiac pain to the left shoulder and arm. In ischemic conditions, cardiac cells are viable
for about 20 minutes. With restoration of blood flow, aerobic metabolism resumes, contractility is
restored, and cellular repair begins.
Chronic Stable Angina refers to chest pain that occurs intermittently over a long period with the same
pattern of onset, duration, and intensity of symptoms.
Risk Factors/Etiology
1. Atherosclerosis
2. Coronary Artery Spasm
3. Anemia
4. Exercise/sexual activity
5. Substance abuse (primarily stimulants such as cocaine)
6. Hyperthyroidism
7. CHF
8. Congenital heart defects
9. Pulmonary hypertension
10. Left Ventricular hypertrophy
11. Cardiomyopathy
12. Eating a heavy meal
, 13. Emotional distress
Clinical Manifestations
Angina: gradual or sudden onset: pain usually lasts less than 15 minutes and not more than 30
minutesusually about 3 minutes.
Location: substernal or anterior chest pain, not sharply localized; radiation to back, neck, arms, jaws,
upper abdomen, or fingers.
Quality and Intensity: mild-to-moderate pressure, deep sensation, varied patterns of attacks. Patient
will c/o tightness, squeezing, crushing or pressure
Patient will also c/o
1. Dyspnea
2. diaphoresis and nausea
3. urge to void
4. belching
5. apprehension
Diagnostic Studies
1. EKG: will show ST depression, T-wave inversion during acute pain
2. Stress test: will have abnormal EKG and patient will likely c/o chest pain
3. Coronary Arteriography: plaque accumulation
4. Serum Chemistry: elevated cholesterol
5. Cardiac Enzymes: within normal limits if patient did not have an MI
6. Holter monitoring: ST depression, T-wave inversion
Treatment Modalities/Collaborative Care
1. Monitor vital signs, EKG, I & O,
2. Semifowler’s, bedrest at first
3. Oxygen via NC
4. Nutrition: Low calorie, low sodium, and low-cholesterol.
5. IV
6. ABG’s; lytes, cardiac enzymes: CK,LD, Troponin, troponin T and AST
7. Possibly: Percutaneous Coronary Interventions
a. Percutaneous Transluminal Coronary Angioplasty:
b. Corornary Artery Stent:
c. Atherectomy
d. Brachytherapy:
Cardiovascular Disorders Study Guide 2025/2026
Molloy College
The Barbara H. Hagan School of Nursing
Nur 2900
Dr. D. Kantor
Topic: Management of the Adult with Acute and Chronic Cardiovascular Disorders
Classroom Learning Objectives:
After completing the required learning activities and participating in classroom activities, the student
will:
1. Utilize the nursing process as a framework for the care of patients who have acute and chronic
cardiovascular disorders.
2. Describe risk factors associated with the development of acute and chronic cardiovascular
disorders.
3. Describe the pathophysiology of acute and chronic cardiovascular disorders..
4. Discuss clinical manifestations, diagnostic studies and collaborative treatment modalities for
patients who have acute and chronic cardiovascular disorders.
5. Discuss the role of the nurse with respect to the treatment of the patient who has acute and
chronic cardiovascular disorders.
6. Provide age appropriate, evidenced-based nursing interventions for the patients who have
acute and chronic cardiovascular disorders.
,DK 7/20
Molloy College
The Barbara H. Hagan School of Nursing
Nur 2900
Dr. D. Kantor
Acute and Chronic Cardiovascular Disorders
1. Angina
Overview: Chest pain due to myocardial ischemia as a result of insufficient oxygen supply to the heart.
Due to atherosclerosis or a blood clot.
The decrease in oxygen and blood supply to the heart leads to changes in cellular metabolism which
results in angina.
On the cellular level, the myocardium becomes hypoxic within the first 10 seconds of coronary
occlusion and with total occlusion of coronary arteries, contractility ceases after several minutes
leading the deprivation of oxygen and glucose for aerobic metabolism to myocardial cells. Anaerobic
metabolism begins and lactic acid accumulates. Lactic acid irritates myocardial nerve fibers and
transmits a pain message to the cardiac nerves and upper thoracic posterior nerve roots. This accounts
for the referred cardiac pain to the left shoulder and arm. In ischemic conditions, cardiac cells are viable
for about 20 minutes. With restoration of blood flow, aerobic metabolism resumes, contractility is
restored, and cellular repair begins.
Chronic Stable Angina refers to chest pain that occurs intermittently over a long period with the same
pattern of onset, duration, and intensity of symptoms.
Risk Factors/Etiology
1. Atherosclerosis
2. Coronary Artery Spasm
3. Anemia
4. Exercise/sexual activity
5. Substance abuse (primarily stimulants such as cocaine)
6. Hyperthyroidism
7. CHF
8. Congenital heart defects
9. Pulmonary hypertension
10. Left Ventricular hypertrophy
11. Cardiomyopathy
12. Eating a heavy meal
, 13. Emotional distress
Clinical Manifestations
Angina: gradual or sudden onset: pain usually lasts less than 15 minutes and not more than 30
minutesusually about 3 minutes.
Location: substernal or anterior chest pain, not sharply localized; radiation to back, neck, arms, jaws,
upper abdomen, or fingers.
Quality and Intensity: mild-to-moderate pressure, deep sensation, varied patterns of attacks. Patient
will c/o tightness, squeezing, crushing or pressure
Patient will also c/o
1. Dyspnea
2. diaphoresis and nausea
3. urge to void
4. belching
5. apprehension
Diagnostic Studies
1. EKG: will show ST depression, T-wave inversion during acute pain
2. Stress test: will have abnormal EKG and patient will likely c/o chest pain
3. Coronary Arteriography: plaque accumulation
4. Serum Chemistry: elevated cholesterol
5. Cardiac Enzymes: within normal limits if patient did not have an MI
6. Holter monitoring: ST depression, T-wave inversion
Treatment Modalities/Collaborative Care
1. Monitor vital signs, EKG, I & O,
2. Semifowler’s, bedrest at first
3. Oxygen via NC
4. Nutrition: Low calorie, low sodium, and low-cholesterol.
5. IV
6. ABG’s; lytes, cardiac enzymes: CK,LD, Troponin, troponin T and AST
7. Possibly: Percutaneous Coronary Interventions
a. Percutaneous Transluminal Coronary Angioplasty:
b. Corornary Artery Stent:
c. Atherectomy
d. Brachytherapy:
