Which patient statement would help the nurse confirm a previous diagnosis of chronic stable angina?
A.
“The pain wakes me up at night.”.
B.
“The pain goes away after taking a nitroglycerin tablet.”.
C.
“The pain is a level 3 to 5 on a 0 to 10 scale.”.
D.
“The pain has worsened over the past week.”.
The Correct answer and Explanation is:
The correct answer is B. “The pain goes away after taking a nitroglycerin tablet.”
Explanation:
Chronic stable angina is characterized by predictable episodes of chest pain or discomfort due to myocardial ischemia, typically triggered by exertion or emotional stress. The defining feature of stable angina is its reproducibility and relief upon rest or the use of sublingual nitroglycerin. When a patient reports that their chest pain alleviates after taking nitroglycerin, it strongly supports the diagnosis of chronic stable angina.
Option A, “The pain wakes me up at night,” is indicative of unstable angina, particularly nocturnal angina, which is not typical for stable angina. Patients with unstable angina often experience pain at rest or with minimal exertion, and this nocturnal presentation raises concern for more serious cardiac events.
Option C, “The pain is a level 3 to 5 on a 0 to 10 scale,” describes the intensity of pain but does not provide sufficient information about its nature or pattern. Stable angina can vary in intensity, and this statement alone does not confirm the chronic stable angina diagnosis.
Option D, “The pain has worsened over the past week,” suggests a change in the pattern or intensity of the angina. In chronic stable angina, pain usually remains consistent over time. A worsening pattern may indicate unstable angina or other cardiovascular issues, requiring further evaluation.
In summary, the statement that the pain resolves with nitroglycerin confirms that the patient experiences typical symptoms of chronic stable angina. This medication works by dilating coronary arteries and improving blood flow, thus alleviating the ischemic pain associated with stable angina episodes. Understanding these key distinctions is crucial for effective assessment and management in nursing practice.