NURS 4530 Active Learning Guide Module 2 - Hard

Lipid Levels and Lifestyle Changes

• Modifiable lifestyle changes can significantly improve lipid levels, enhancing cardiovascular health.
• Reducing saturated and trans fats lowers Low-Density Lipoproteins (LDL).
• Increasing soluble fiber intake from sources like oats, vegetables, and fruits aids in reducing cholesterol absorption.
• Consuming fish or flaxseed boosts omega-3 fatty acids, which elevate High-Density Lipoproteins (HDL) and lower triglycerides.
• Regular aerobic exercise (walking, cycling, running) raises HDL and reduces LDL levels.
• Weight management decreases total cholesterol, LDL, and triglycerides while improving HDL.
• Smoking cessation not only enhances HDL but also lowers overall cardiovascular risk.

Coronary Artery Disease (CAD)

• CAD arises from arterial narrowing/blocking due to plaque buildup, known as atherosclerosis.
• Initiation occurs with endothelial damage, influenced by high blood pressure, high cholesterol, diabetes, or smoking.
• Endothelial damage leads to inflammation and accumulation of LDL in arterial walls.
• Oxidized LDL attracts macrophages, leading to foam cell formation and fatty streaks.
• Sustained fatty streak development results in fibrous plaque, narrowing arteries progressively.
• Unstable plaques may rupture, causing blood clots, resulting in heart attacks.
• Genetic predisposition and social determinants like family history influence CAD risk.

Health Belief Model (HBM) Concepts

• Perceived Susceptibility: Belief about the likelihood of developing a condition.
• Perceived Severity: Belief regarding the seriousness of the condition.
• Perceived Benefits: Belief in the effectiveness of an action to reduce health risks.
• Perceived Barriers: Beliefs about the costs (tangible and psychological) of the advised action.
• Cues to Action: Environmental strategies or conditions that prompt action.
• Self-Efficacy: Confidence in one's ability to take action to mitigate health risks.

Transtheoretical Model (TTM) & Stages of Change

• Change is a process that unfolds over time through distinct stages: Precontemplation, Contemplation, Preparation, Action, and Maintenance.
• Decisional Balance involves weighing pros (benefits) and cons (costs) of behavior change.
• This model assists in patient education by helping patients recognize the advantages and challenges associated with behavioral changes.

Risk Factors

• Risk is defined as the probability of an event occurring within a time frame.
• Modifiable Risks: Factors like diet, smoking, and exercise that individuals can control.
• Non-Modifiable Risks: Genetic or demographic factors such as age and family history that cannot be controlled.

Smoking Trends

• Most individuals begin smoking between ages 18-25.
• Although smoking rates have declined since the 1990s, many high school students smoke more than adults.
• Teen smokers often struggle more to quit later in life.

Sleep Recommendations

• Sleep needs vary by age; adults need 7-9 hours, with newborns requiring 10.5-18 hours.

Lipid Panel Testing

• Includes Total Cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
• Normal ranges for lipid panel tests:
  • Total Cholesterol: <200 mg/dL
  • LDL: 100-129 mg/dL
  • HDL: Men ≥40 mg/dL, Women ≥50 mg/dL
  • Triglycerides: <150 mg/dL
• Recommended screenings: Adults should have fasting lipid profiles; those with CAD risk factors should be tested annually.

Inflammation and CAD

• High-sensitivity C-reactive protein (hs-CRP) measures inflammation levels indicative of CAD risk.
• Chronic inflammation contributes to endothelial dysfunction, plaque formation, and instability.
• Strategies to lower chronic inflammation include regular exercise, anti-inflammatory diets, stress management, and cessation of smoking.

Blood Pressure Ranges

• Normal blood pressure: <120/80 mm Hg.
• Stages of hypertension:
  • Elevated: 120-129 systolic / 80-89 diastolic
  • Stage 1: 130-139 systolic / 80-89 diastolic
  • Stage 2: ≥140 systolic / ≥90 diastolic
  • Hypertensive Crisis: ≥180 systolic / ≥120 diastolic
• Adults should undergo routine blood pressure checks starting at age 18.

Blood Glucose Levels

• Normal fasting blood glucose: 80-130 mg/dL
• Normal postprandial blood glucose: <180 mg/dL.

Lipid Levels Improvement

• Reducing saturated and trans fats lowers Low-Density Lipoproteins (LDL).
• Increasing soluble fiber from sources like oats, vegetables, and fruits decreases cholesterol absorption.
• Consuming fish or flaxseed boosts Omega-3 fatty acids, enhancing High-Density Lipoproteins (HDL) and reducing triglycerides.
• Regular aerobic exercise (walking, cycling, running) raises HDL and lowers LDL.
• Weight management decreases total cholesterol, LDL, and triglycerides while improving HDL.
• Quitting smoking improves HDL levels and reduces overall cardiovascular risk.

Coronary Artery Disease (CAD) Development

• CAD arises from narrowing/blocking of arteries due to plaque buildup (atherosclerosis).
• Initial endothelial damage from high blood pressure, cholesterol, diabetes, or smoking leads to inflammation.
• Accumulation of LDL in artery walls creates fatty streaks; oxidized LDL attracts macrophages, forming foam cells.
• Continued fatty streak development results in fibrous plaque that narrows arteries.
• Unstable plaques may rupture, causing blood clots that can block heart blood flow, potentially resulting in heart attacks.
• Genetic factors, lifestyle choices, and community health attributes contribute to individual CAD risk.

Health Promotion and Risk Education

• Pender’s Health Promotion Model focuses on biopsychosocial elements influencing healthy behaviors.
• Health Belief Model is utilized for guiding health education and promotion.
• Risk communication informs public about health threats and is influenced by perception, processing, and action on information.
• Clear communication is vital to mitigate misunderstanding during health crises like the early COVID pandemic.

Smoking as a Public Health Issue

• Leading cause of preventable death in the U.S., accounting for approximately 438,000 deaths annually.
• Causal factor in various cancers (esophagus, bladder, lung) with over 90% of lung cancers in men and 80% in women attributed to smoking.
• Smoking prevalence is higher among less educated adults and those below the poverty level, particularly in the Midwest.
• Over 70% of smokers express a desire to quit but often start smoking between ages 18-25.

Sleep Needs by Age

• Newborns (1-2 months): 10.5-18 hours
• Infants (3-11 months): 9-12 hours at night + 1-4 hours of naps
• Toddlers (1-3 years): 12-14 hours
• Preschoolers (3-5 years): 11-13 hours
• School-aged children (5-12 years): 10-11 hours
• Teens (11-17 years): 8.5-9.25 hours
• Adults and older adults: 7-9 hours

Lipid Panel Tests

• Total Cholesterol: Normal < 200 mg/dL.
• LDL Cholesterol: Normal 100-129 mg/dL.
• HDL Cholesterol: Normal men ≥ 40 mg/dL, women ≥ 50 mg/dL.
• Triglycerides: Normal < 150 mg/dL.
• Screening recommendations include fasting lipid profiles for adults and annual tests for at-risk individuals.

Hemoglobin A1c

• Reflects average blood glucose over 3 months; percentage of glucose attached to hemoglobin.
• A1c to average blood glucose correlation (e.g., A1c of 6.0% correlates with 126 mg/dL average glucose).

Diabetes Criteria

• Pre-diabetes: Fasting glucose 100-125 mg/dL, A1c 5.7%-6.4%, Oral Glucose Tolerance Test (OGTT) 140-199 mg/dL.
• Diabetes: Fasting glucose ≥ 125 mg/dL, A1c ≥ 6.5%, OGTT ≥ 200 mg/dL.

Colorectal Cancer Screening

• Recommended for adults 45+ years, with continued screening until 75, and potentially until 85 based on history.
• Options include stool-based tests and visual exams.

Importance of Screening Colon Cancer

• Early detection through screening can prevent cancer progression and improve treatment outcomes.