Questions and Answers
Which ethnic group would the nurse select as the highest priority for health promotion teaching targeted at preventing coronary artery disease (CAD)?
Which individuals would the nurse identify as having the highest risk for CAD?
When providing nutritional counseling for patients at risk for CAD, which foods should the nurse encourage patients to include in their diet? (Select all that apply)
Which antilipemic medications should the nurse question for a patient with cirrhosis of the liver? (Select all that apply)
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After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient makes which statement?
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The nurse would assess a patient with complaints of chest pain for which clinical manifestations associated with a myocardial infarction (MI)? (Select all that apply)
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Study Notes
Coronary Artery Disease (CAD) Risk Factors
- Highest incidence of CAD and myocardial infarction (MI) found in white, middle-aged men.
- African Americans experience earlier onset and more severe forms of CAD, with over twice the mortality rate compared to white males of the same age.
- Native Americans have a high mortality rate in individuals under 35, with significant risk factors including diabetes.
High-Risk Individuals for CAD
- A 45-year-old male with depression and a high-stress job is at the highest risk for developing CAD due to the psychological and physiological stress factors associated with his condition.
- Elevated HDL levels and low homocysteine levels are protective against CAD.
- A sedentary lifestyle, while a recognized risk, is coupled with normal BMI in a 62-year-old female, reducing her overall risk.
Nutritional Guidance for CAD Prevention
- Foods rich in omega-3 fatty acids that should be encouraged include:
- Tofu
- Walnuts
- Tuna fish
- These foods help to mitigate risks associated with CAD when consumed regularly.
Contraindications in Antilipemic Medications
- Ezetimibe (Zetia) and atorvastatin (Lipitor) are contraindicated for patients with liver disease due to their potential for liver impairment and damage.
- Niacin may cause decreased liver function at high doses but side effects tend to decrease over time.
- Cholestyramine is safe for long-term use in patients with liver conditions.
Nitroglycerin Usage in Angina Management
- Correct understanding includes replacing nitroglycerin every 6 months, taking acetaminophen for headaches, and administering nitroglycerin before activities that trigger chest pain.
- Misunderstanding arises from stating five tablets may be taken every three minutes—only one tablet can be taken every five minutes, with a maximum of three doses before seeking emergency help if symptoms persist.
Clinical Manifestations of Myocardial Infarction (MI)
- Key signs indicating an MI include:
- Ashen, cool, and clammy skin (not flushed)
- Diaphoresis (sweating)
- Nausea and vomiting due to pain-induced reflex stimulation
- Abnormal heart sounds (S3 and S4) resulting from ventricular dysfunction during MI
- The presence of catecholamines during MI increases sympathetic nervous system activity, affecting these clinical manifestations.
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Description
Test your knowledge on coronary artery disease and acute coronary syndrome in this Medical-Surgical Nursing Chapter 33 quiz. Focus on key concepts such as risk factors, ethnic groups, and health promotion strategies in preventing CAD and MI.
