Angina Pectoris — NCLEX Cheat Sheet
Chest pain, no muscle deathAlso known as: angina · chest pain · stable angina · chest tightness
Use this quick-reference guide to spot, treat, and prevent Angina Pectoris on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
📌 Types
- Stable: exertion, relieved by rest
- Unstable: at rest, worsening
- Variant: vasospasm at rest
🩺 Signs
- Pressure/tightness < 15 min
- Relieved by rest + nitro
🧪 Meds
- Nitro SL q5min x3, then call
- Sit down, no Viagra w/ nitro
- Beta-blockers, CCBs, ASA
🚩 Report
- Pain unrelieved = possible MI
📚 Angina Pectoris — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Stable angina is triggered by exertion, emotion, heavy meals, or cold and is relieved by rest and nitroglycerin within minutes.
- Unstable angina occurs at rest, lasts longer, and is increasing in frequency or severity, signaling impending infarction.
- Variant (Prinzmetal) angina is caused by coronary artery spasm and often occurs at rest, frequently overnight.
- Pain is typically substernal pressure or tightness that may radiate to the arm, jaw, or back, lasting less than 15 minutes.
- Cardiac biomarkers such as troponin remain normal in angina, which distinguishes it from myocardial infarction.
Nursing priorities
What to do, in order- Stop activity, have the patient rest, and assess pain, vital signs, and obtain an ECG.
- Administer sublingual nitroglycerin every 5 minutes up to 3 doses, checking blood pressure before each dose.
- Apply oxygen if the patient is hypoxic and provide continuous cardiac monitoring.
- If pain is unrelieved after 3 nitroglycerin doses, treat as an evolving MI and notify the provider immediately.
- Reduce myocardial oxygen demand by promoting rest and calm and managing anxiety.
Red flags — report now
Escalate immediately- Chest pain unrelieved by 3 nitroglycerin doses over 15 minutes may indicate myocardial infarction and requires emergency care.
- New onset of pain at rest or pain that is increasing in frequency or duration (unstable angina) must be reported immediately.
- Do not give nitroglycerin if systolic blood pressure is below 90 mmHg or the patient has taken erectile dysfunction drugs (risk of severe hypotension).
Labs & values
Numbers to know- Troponin: normal in angina (less than 0.04 ng/mL); elevation indicates infarction instead
- Lipid panel: LDL goal less than 100 mg/dL, HDL greater than 40 mg/dL
Patient teaching
What patients must know- Carry nitroglycerin at all times, store it in a dark container, and replace it every 6 months as potency fades.
- Take nitroglycerin sitting down because it can cause dizziness and low blood pressure, and expect a brief headache.
- Avoid known triggers such as heavy exertion, large meals, extreme cold, and smoking, and report any change in pain pattern.
❓ Angina Pectoris: NCLEX FAQs
What are the priority nursing interventions for Angina Pectoris?
Stop activity, have the patient rest, and assess pain, vital signs, and obtain an ECG. Administer sublingual nitroglycerin every 5 minutes up to 3 doses, checking blood pressure before each dose. Apply oxygen if the patient is hypoxic and provide continuous cardiac monitoring. If pain is unrelieved after 3 nitroglycerin doses, treat as an evolving MI and notify the provider immediately.
What are the warning signs of Angina Pectoris a nurse must report?
Chest pain unrelieved by 3 nitroglycerin doses over 15 minutes may indicate myocardial infarction and requires emergency care. New onset of pain at rest or pain that is increasing in frequency or duration (unstable angina) must be reported immediately. Do not give nitroglycerin if systolic blood pressure is below 90 mmHg or the patient has taken erectile dysfunction drugs (risk of severe hypotension).
What do I need to know about Angina Pectoris for the NCLEX?
Stable angina is triggered by exertion, emotion, heavy meals, or cold and is relieved by rest and nitroglycerin within minutes. Unstable angina occurs at rest, lasts longer, and is increasing in frequency or severity, signaling impending infarction. Variant (Prinzmetal) angina is caused by coronary artery spasm and often occurs at rest, frequently overnight. Pain is typically substernal pressure or tightness that may radiate to the arm, jaw, or back, lasting less than 15 minutes.
What patient teaching is important for Angina Pectoris?
Carry nitroglycerin at all times, store it in a dark container, and replace it every 6 months as potency fades. Take nitroglycerin sitting down because it can cause dizziness and low blood pressure, and expect a brief headache. Avoid known triggers such as heavy exertion, large meals, extreme cold, and smoking, and report any change in pain pattern.
Quick Tip
Stable angina is triggered by exertion, emotion, heavy meals, or cold and is relieved by rest and nitroglycerin within minutes.
📖 Related Topics
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