a)EXERCISE AND REST
We as nurses should advise Mr. Zainal to do the exercise in order for him to remain physically active but with suitable physical activity. However, it is advisable for him to consult the physiotherapist first so that he will know the suitable physical activity before starting the activities. He can have brisk walking exercise and jogging and yoga.
b)SMOKING ENVIRONMENT
We should advise Mr. Zainal to avoid the smoking environnent. We should educate him that smoke can increase his risk to have the severe unstable angina and can lead to myocardial infarction because the cigarette contains dangerous ingredient such as tobacco. Tobacco can induce the formation of fatty plaque at the artery and cause coronary artherosclerosis. Thus, we remind him to stay away from the smoker.
c)DIET
As Mr. Zainal has Diabetes Mellitus and Hypertension, we as the nurses should collaborate with dietition to emphasize the importance of having balance diet to him. With having balance diet, it will reduce the factors for Mr. Zainal to have severe unstable angina. He has to reduce the consumption of sodium or salt as it can reduce his hypertension. He also should limits himself from taking the sweets food such as cookies, chips and many more foods that have high level of sugar to lower down his glucose level. He also should avoid the processed food as it has many sodium.
d)THE MEDICATION
We should teach Mr. Zainal the correct way to take medication prescribed by the doctor such as nitroglycerin. This medication is to prevent angina attacks. We should tell the right dosage of the medications to avoid medication error. We as the nurses also should tell him to take all medications such as for hypertension and diabetes in order for him to avoid any further complications. Encourage Mr. Zainal to inform the doctor right away if unwanted side effects from the medications.
e)PHYSOCOSOCIAL MANAGEMENT
Mr. Zainal should have a good environment because stress will make his condition become more worst. He should manage his stress properly. If he very stress, it is advisable for him to seek the counsellor . We should tell him that stress will increase his blood pressure and will cause the second unstable angina occurs again.