Nurses play a very important role in managing a patient from the time of admission to developing a discharge plan. Every step of the nursing process is essential to the well-being of the person it cares for. Clinical reasoning is still essential in every step of the nursing process, from assessment, goal setting, and intervention. Effective nursing management is achieved when a nurse looks for early and appropriate signals in the right patient and implements them at the right time. This essay will delve deeper into the case of Rob Geis, a patient who suffered from angina, considering his history and the signs and symptoms he experienced until his condition worsened until myocardial infarction. This essay will also examine how the nurse should provide effective nursing care to the patient with this condition. Etiology and Pathophysiology of Angina Angina is pain felt in the chest region due to insufficient supply to the myocardium (Better Health Channel, 2013). ) Atherosclerosis or hardening and narrowing of arteries caused by accumulation of plaques, insufficient supply of oxygen and its increasing demand are some of the factors that can cause myocardial ischemia (Lewis et al., 2012 ). When there is a total blockage of the coronary arteries for a few minutes, the myocardium cannot receive oxygen and glucose for aerobic metabolism, resulting in anaerobic metabolism (Lewis et al., 2012). Lactic acid accumulates and stimulates nerve fibers in the myocardium, leading to chest pain (Lewis et al., 2012). Cells are repaired and aerobic metabolism and contractility of arteries are restored when blood flow returns (Lewis et al., 2012)Subjective and Objective...... middle of article.... ...). New South Wales: Elsevier Australia.MedlinePlus. (2010). Atenolol. Accessed April 4, 2014, from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684031.htmlRull, G. (2011). Cardiogenic shock. Accessed April 2014 from http://www.patient.co.uk/doctor/Cardiogenic-Shock.htm Smeltzer, S., Bare, B., Farrell, M. and Dempsey, J. (2011). Smeltzer & Bare's Textbook of Medical-Surgical Nursing (2nd Australian and New Zealand ed. Vol. 1): Lippincott Williams & Wilkins Pty Ltd.WebMD. (2012). Electrocardiogram. Retrieved April 1, 2014 from http://www.webmd.com/heart-disease/electrocardiogramWilliams, BR, Lewis, DR, Burgio, KL, & Goode, PS (2012). Next of kin perceptions of how hospital nurses support family presence before, during, and after the death of a loved one. Journal of Hospice and Palliative Care, 14(8), 541-550.