Cardiovascular Health: MI and CAD Risks

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Questions and Answers

What disorder is the client at risk for given the constant crushing chest pain rated at 9 out of 10?

Myocardial infarction (MI) (correct)

Atherosclerosis

Coronary artery disease (CAD)

Stable angina

What characterizes stable angina compared to unstable angina?

It is predictable and occurs with exertion (correct)

It does not respond to rest or medication

It is unpredictable and occurs at rest

It is indicative of immediate myocardial infarction

Which action should the nurse take to encourage additional physical activity in a mildly obese older adult client with coronary artery disease?

Recommending that older adults should exercise no more than 15 minutes at a time

Teaching the client to warm up, stretch, and cool down before and after all physical activities

Telling the client that moderate exercise can lead to 2 pounds of weight loss per week

Asking the client what kind of exercise or activities she likes to do (correct)

Why is ibuprofen not recommended for increasing blood flow to the coronary arteries?

It is an anti-inflammatory medication with little effect on blood flow Signup and view all the answers

What is a common misunderstanding regarding the exercise limitations for older adults?

Older adults should exercise no more than 15 minutes at a time Signup and view all the answers

Which statement about chronic conditions and chest pain is true?

Stable angina occurs with predictable triggers Signup and view all the answers

What is a potential consequence of untreated unstable angina in a patient?

It can progress to a myocardial infarction Signup and view all the answers

What role does patient preference play in encouraging exercise in older adults with coronary artery disease?

Incorporating preferences can enhance motivation for exercise Signup and view all the answers

What position should a patient with left-sided heart failure be placed in to facilitate easier breathing?

High Fowler's position Signup and view all the answers

Which patient is at the highest risk for exacerbation of heart failure?

A 73-year-old male who has not taken Amiodarone for one month and is experiencing atrial fibrillation Signup and view all the answers

What is the recommended sodium intake limit for patients with heart failure?

2-3 grams per day Signup and view all the answers

Which dietary statement indicates that a patient with heart failure understands their discharge teaching?

I will limit my consumption of frozen meals. Signup and view all the answers

What symptom is commonly associated with left-sided heart failure?

Dyspnea and crackles in the lungs Signup and view all the answers

Why should patients with heart failure avoid canned vegetables and fish?

They typically contain high sodium levels. Signup and view all the answers

What implication does not taking Amiodarone have for a patient with atrial fibrillation?

Increased likelihood of worsening heart rhythm control Signup and view all the answers

What would be a common assessment finding in a patient with heart failure?

Swelling in the feet and legs Signup and view all the answers

Which of the following symptoms is associated with heart failure?

Persistent cough Signup and view all the answers

What dietary component should be monitored closely in patients at risk for CAD?

Daily weights Signup and view all the answers

Which food is encouraged for patients at risk for CAD due to its omega-3 fatty acids content?

Tofu Signup and view all the answers

What can untreated left-sided heart failure potentially lead to?

Right-sided heart failure Signup and view all the answers

Which finding would indicate left-sided systolic dysfunction heart failure?

Ejection fraction of 38% Signup and view all the answers

Which of the following foods is NOT encouraged for patients at risk for CAD?

Whole milk Signup and view all the answers

Difficulty breathing while lying down is a symptom of which type of heart failure?

Left-sided heart failure Signup and view all the answers

What condition can result from increased pressure in the hepatic veins due to heart failure?

Peripheral edema Signup and view all the answers

What should be emphasized over the amount of weight loss for older, obese clients?

The benefits of weight loss Signup and view all the answers

What is the recommended duration of moderate activity for older adults?

30 minutes, on most days Signup and view all the answers

Which client statement indicates successful teaching about managing symptoms of coronary artery disease?

Increasing my physical activity will help manage my symptoms. Signup and view all the answers

Who is identified as having the highest risk for coronary artery disease?

A 45-year-old depressed male with a high-stress job Signup and view all the answers

Which statement about left ventricular systolic dysfunction is NOT correct regarding discharge teaching?

It can be fully cured with medication. Signup and view all the answers

What lifestyle factor may help prevent coronary artery disease despite being a risk factor?

Low homocysteine levels Signup and view all the answers

What is a potential misconception about the body mass index (BMI) regarding coronary artery disease risk?

A BMI of 30 kg/m2 indicates low risk. Signup and view all the answers

Which dietary practice can contribute to lowering CAD risk?

Adopting a vegetarian diet Signup and view all the answers

Which patient is most likely to develop left-sided diastolic dysfunction heart failure?

A 55-year-old female with asthma and hypoparathyroidism. Signup and view all the answers

What is the primary concern for the 69-year-old male recovering from a myocardial infarction?

He is at risk for left-sided heart failure. Signup and view all the answers

Which symptom suggests a patient is experiencing a heart failure exacerbation?

A 6 lb weight gain within one week. Signup and view all the answers

Which therapeutic position is most appropriate for a patient with left-sided heart failure experiencing difficulty breathing?

High Fowler's position. Signup and view all the answers

What is a correct statement regarding the male patient with endocarditis and severe mitral stenosis?

He is at risk for left-sided heart failure. Signup and view all the answers

In which condition would a patient most likely exhibit diastolic dysfunction heart failure?

Severe hypertension. Signup and view all the answers

Which of the following conditions is least associated with developing heart failure?

Controlled hypertension. Signup and view all the answers

What can indicate that a patient with heart failure might be experiencing an exacerbation?

Propping up with pillows while sleeping. Signup and view all the answers

Study Notes

Myocardial Infarction (MI) Risk Factors

Constant, crushing chest pain (9/10 intensity) increasing over 30 minutes indicates high MI risk.
Unstable angina, unlike predictable exertion-related chest pain, significantly increases MI risk.
Atherosclerosis is a long-term condition, not a direct cause of the described acute pain.
Coronary artery disease (CAD) is a contributing factor to chest pain, but not the immediate disorder causing the described symptoms.

Managing Coronary Artery Disease (CAD)

Daily salicylic acid (aspirin) use to improve blood flow is a beneficial practice.
Discontinuing Lipitor (a cholesterol-lowering medication) is detrimental.
Ibuprofen does not improve blood flow to the heart.
Avoiding daily pain relievers for chest pain is important; this may mask a serious problem requiring attention.

CAD Risk Assessment

A 45-year-old depressed male with a high-stress job presents the highest CAD risk due to stress and depression being contributing factors.
High HDL levels and low homocysteine levels are protective against CAD.
Sedentary lifestyle increases risk, but a normal BMI (23 kg/m²) is less of a factor than stress, depression, and other lifestyle choices.

Nutrition for CAD Prevention

Include foods rich in omega-3 fatty acids in the diet, such as tofu, walnuts, and tuna.
Whole milk and orange juice (as examples) are not identified in the text as particularly relevant for CAD prevention or treatment.

Heart Failure Risk Factors

A 69-year-old male with alcohol abuse history recovering from an MI is at high risk due to history of MI and long-term effects of alcohol.
A 30-year-old male with endocarditis and severe mitral stenosis is at high risk due to valvular heart disease complications.
A 58-year-old female with uncontrolled hypertension and influenza is at high risk due to high blood pressure and infection.
Asthma and hypoparathyroidism (in the 55-year-old female) and lung cancer (in the 45-year-old female) are not identified as primary heart failure risk factors in this context.

Left Ventricular Systolic Dysfunction

Left-sided heart failure symptoms include dyspnea, persistent cough, orthopnea (difficulty breathing lying down), and weight gain.
Daily weight monitoring, fluid, and sodium intake are crucial elements of management.
Untreated left-sided heart failure can lead to right-sided heart failure.
Peripheral edema is associated with right ventricular failure, not left ventricular systolic dysfunction. Fluid backs up into the lungs in left-sided failure, causing pulmonary edema.

Diagnosing Left-Sided Systolic Dysfunction

An echocardiogram showing an ejection fraction (EF) of 38% is an expected finding (normal EF >60%).
Nocturnal paroxysmal dyspnea (sudden shortness of breath at night) is also an expected finding.
An EF of 65% on heart catheterization is indicative of left-sided diastolic dysfunction, not systolic.

Heart Failure Exacerbation

A 6-pound weight gain in one week could signal heart failure exacerbation, reflecting fluid retention.
Orthopnea (sleep propped upright due to breathing difficulty) indicates potential exacerbation due to fluid in the lungs.
Absence of foot/hand swelling does not rule out exacerbation as fluid can build up in other areas first.

Heart Failure Exacerbation Risk

A 73-year-old male not taking Amiodarone (anti-arrhythmic medication) and experiencing atrial fibrillation (irregular heartbeat) is at high risk; a-fib can lead to heart failure.
A 78-year-old male with eczema and cystic fibrosis does not have risk factors identified here as directly contributing to heart failure exacerbation.

Lab Values and Heart Failure

Elevated Troponin levels (600 pg/mL or above) indicate myocardial damage; values above 900 pg/mL represent severe damage.
BUN (Blood Urea Nitrogen) of 9 is within normal range and does not immediately signal heart failure.

Managing Left-Sided Heart Failure Dyspnea

Placing the patient in a High Fowler's position is the best immediate intervention to improve breathing by reducing pressure on the lungs.
Coughing, deep breathing, and chest percussion are helpful in some respiratory issues, but the primary focus should be postural drainage.

Heart Failure Diet Teaching

Limiting sodium intake to 2-3 grams per day demonstrates understanding of dietary restrictions.
Avoiding canned vegetables, fish (due to high sodium), and processed sandwich meats/cheeses is critical.
Limiting frozen meals is reasonable given their often high sodium content.

Patient Mobility with Edema

The text contains a scenario of assisting a patient with leg and foot swelling from bed to the bathroom, but offers no specific guidance or teaching points related to this interaction.

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Description

This quiz explores the risk factors associated with Myocardial Infarction (MI) and Coronary Artery Disease (CAD). Understand the symptoms, management strategies, and key factors that elevate the risk of these serious cardiovascular conditions. Test your knowledge on how to recognize and manage these risks effectively.